乳腺癌患者术后淋巴水肿相关知识、危险因素及行为状况的研究  

Investigation on postoperative lymphedema-related knowledge, risk factors and behaviors of breast cancer patients

作　　者：赵权萍[1] 李凤莲 路潜[2] Zhao Quanping;Li Fenglian;Lu Qian(Department of Breast Surgery,People’s Hospital of Peking University,Beijing 100044,China;School of Nursing,Peking University,Beijing 100191,China)

机构地区：[1]北京大学人民医院乳腺外科,100044 [2]北京大学护理学院,100191

出　　处：《中华乳腺病杂志（电子版）》2019年第5期296-300,共5页Chinese Journal of Breast Disease(Electronic Edition)

基　　金：北京大学医学部护理科研基金(BMU20160517)

摘　　要：目的探讨乳腺癌患者术后淋巴水肿相关知识、危险因素及相关行为,分析目前临床健康指导对其的影响。方法根据纳入及排除标准,选取2017年4~8月在北京大学人民医院乳腺中心就诊的169例乳腺癌术后患者进行回顾性研究,并根据研究对象是否接受过淋巴水肿健康指导,分为有指导组(85例)和无指导组(84例)。采用相关调查表分别评估患者的淋巴水肿相关知识掌握情况、危险因素发生情况及行为情况,并比较2组在这3个方面的差异。正态分布数据采用x±s表示,偏态分布数据用M(P25~P 75)表示。问卷得分的组间比较采用两独立样本t检验或秩和检验;率的比较采用χ^2检验及Fisher精确概率法。结果有指导组患者的淋巴水肿相关知识得分为(15±3)分,高于无指导组的(13±3)分(t=6.169,P=0.014)。有指导组患者的淋巴水肿相关危险因素得分为1(0~3)分,无指导组为2(1~5)分,组间差异具有统计学意义(Z=1.514,P=0.020)。无指导组的淋巴水肿相关危险行为得分为17(16~18)分,有指导组为17(16~18)分,2组比较,差异无统计学意义(Z=0.438,P=0.991);而有指导组的淋巴水肿相关保护行为得分及总得分均高于无指导组[3(3~5)分比3(1~4)分,Z=1.795,P=0.003;20(19~22)分比19(18~21)分,Z=1.645,P=0.009]。结论淋巴水肿相关健康指导可以提高患者的相关知识水平,降低相关危险因素的发生率,改善患者的相关行为。目前临床护理工作对于乳腺癌术后患者淋巴水肿的相关健康教育有待改善。Objective To investigate the postoperative lymphedema-related knowledge,risk factors and behaviors of patients with breast cancer and analyze the impact of health guidance in clinic.Methods According to the inclusion and exclusion criteria,169 breast cancer patients who underwent surgery in the Department of Breast Surgery,People’s Hospital of Peking University from April to August 2017 were enrolled for a retrospective study.They were divided into two groups:group A(n=85)in which all patients received health guidance related to postoperative lymphedema and group B(n=84)in which all patients received no health guidance.The related questionnaires were delivered to evaluate the lymphedema-related knowledge,risk factors and behaviors of breast cancer patients.The data with normal distribution were expressed as x±s and the data with skewed distribution were expressed as M(P 25-P 75).The scores in the three questionnaires were compared between two groups using t test of two independent samples and rank sum test.The rate comparison was performed by χ^2 test and Fisher exact test.Results The score in lymphedema related knowledge questionnaire was 15±3 in group A,significantly higher than 13±3 in group B(t=6.169,P=0.014).The score in risk factor evaluation was 1(0-3)in group A and 2(1-5)in group B,indicating a significant difference between two groups(Z=1.514,P=0.020).The score in risk behavior evaluation was 17(16-18)in group A,17(16-18)in group B,suggesting no significant difference between two groups(Z=0.438,P=0.991).The score in protective behaviors and total score in group A were significantly higher than those in group B[3(3-5)vs 3(1-4),Z=1.795,P=0.003;20(19-22)vs 19(18-21),Z=1.645,P=0.009].Conclusions Lymphedema-related health guidance can increase patients’knowledge on postoperative lymphedema,reduce the relevant risk factors and improve their daily behaviors.It is necessary to promote health education concerning to lymphedema in breast cancer patients after surgery in clinical nursing.

关 键 词：乳腺肿瘤 淋巴水肿 健康教育 知识 危险因素 保护行为 

分 类 号：R737.9[医药卫生—肿瘤]