乳腺癌个案管理师的设立及医护联合康复门诊管理实践  

Construction and implementation of the rehabilitation clinic for breast cancer patients after operation

作　　者：王影新[1] 刘飞 王悦[1] 谷洪涛[1] WANG Yingxin;LIU Fei;WANG Yue;GU Hongtao(Surgical Department, Peking University First Hospital, Beijing, 100034, China)

机构地区：[1]北京大学第一医院普通外科,北京市100034

出　　处：《中国护理管理》2019年第4期602-606,共5页Chinese Nursing Management

摘　　要：为规范乳腺癌术后康复患者的管理,我院于2018年7月构建医护联合康复门诊,由乳腺外科医生、乳腺癌个案管理师组成医护照护团队,医生负责诊断和治疗,个案管理师(淋巴水肿治疗师)负责康复档案管理、患肢功能障碍的评估与干预、淋巴水肿的评估与干预、健康教育。医护联合康复门诊设立6个月,共进行患肢功能障碍护理干预22人次,其中8人干预1～2周后顺利达到放疗体位要求,14人干预一个月后,肩关节前屈活动度、外展活动度的达标率均显著提高(P<0.05);共进行淋巴水肿治疗干预31人,共计提供干预309次,干预后,患侧与健侧各测量部位周径差值均显著低于干预前(P<0.05)。乳腺癌个案管理师可在医护联合康复门诊中发挥重要作用,实现乳腺癌术后康复的综合管理,是乳腺癌全程管理的重要环节。To standardize the management of breast cancer patients, a rehabilitation clinic for breast cancer survivors was established in July 2018 and managed by a medical team composed of a surgeon and a nurse as breast cancer case manager. The surgeon was in charge of diagnosis and treatment while the nurse focused on rehabilitation records, limb dysfunction and lymphedema treatment and health education. For patients with limb dysfunction, the nurse was responsible for the assessment of shoulder joint mobility and individualized guidance of limb rehabilitation. The nurse as case manager also qualified as lymphedema therapist, who can evaluate the lymphedema status and implement comprehensive treatment.In 6 months, twenty-two patients with limb dysfunction were intervened, and showed significant improvement in the flexion and abduction of shoulder(P<0.05). Thirty-one patients with lymphedema were treated for 309 times totally, and the diameter of the affected arm and the unaffected arm were significantly decreased respectively(P<0.05). The rehabilitation clinic can carry out the comprehensive management of the breast cancer patients. The nurses as case managers play an important role during the whole process management of breast cancer patients.

关 键 词：乳腺癌 个案管理师 淋巴水肿治疗师 医护联合门诊 康复 

分 类 号：R47[医药卫生—护理学]