“互联网+”护理模式在乳腺癌患者术后淋巴水肿干预中的应用  

The application effect of "Internet +" nursing mode intervention on lymphedema among postoperative patients with breast cancer

作　　者：岳朝丽 徐海萍[1] 孙莉 谢春晓 YUE Chaoli;XU Haiping;SUN Li;XIE Chunxigo(Breast Surgery Department,Jiangsu Provincial Hospital,Nanjing,210036,China)

机构地区：[1]江苏省人民医院乳腺外科,南京210036 [2]江阴市人民医院护理部

出　　处：《中国护理管理》2020年第5期670-676,共7页Chinese Nursing Management

基　　金：2018年度江苏省妇幼健康科研项目(F201821)。

摘　　要：目的:评价“互联网+”护理模式在乳腺癌患者术后淋巴水肿干预中的应用效果.方法:选取2018年4-12月首次行“乳腺癌改良根治术”的294例患者为研究对象,以4-6月的住院患者为对照组(n=146),以10-12月的住院患者为干预组(n=148).对照组患者术后行常规康复指导;干预组在常规护理基础上行“互联网+”护理模式下的康复护理;选择术前1日,术后1、3、6、12个月,分别采集乳腺癌患者淋巴水肿症状相关参数,进而获取水肿表征出现及相关困扰情况等指标,并结合两组患者健患肢周径差进行淋巴水肿的早期监测.结果:两组患者在术后1个月健患肢的周径差比较差异有统计学意义(P<0.05),干预组患者在术后12个月内未发生淋巴水肿,对照组患者在术后12个月时发生2例淋巴水肿;两组患者症状出现、症状困扰、症状体验在时间及组间效应方面差异均有统计学意义(P<0.05).结论:对于术后乳腺癌患者淋巴水肿改善情况,“互联网+”护理模式能发挥显著效用,具有较大的临床应用潜力.Objective: To explore the application effect of "Internet +" nursing mode intervention on lymphedema among postoperative breast cancer patients. Methods: A total of 294 patients who underwent radical mastectomy of breast cancer from April to December 2018 were recruited and divided into the control group(from April to June) and the intervention group(from October to December). Patients in the control group received routine rehabilitation guidance after surgery, while the patients in the intervention group received the "Internet +" nursing mode based on the routine rehabilitation. We collected the data of the parameters of lymphedema symptoms at 1 day before surgery and 1, 3, 6, 12 months after sugery, separately, and then related indicators such as edema appearance and related distress. We also compared the difference in peripheral limb diameters between the two groups and conducted the early monitoring of lymphedema. Results: The difference of the peripheral limbs between the two groups was statistically significant at 1 month after operation(P<0.05). The patients in the intervention group did not develop breast cancer related upper extremity lymphedema within 12 months after surgery, but two patients in the control group developed lymphedema. The results of repeated measures analysis of variance showed statistically significant differences in the edema appearance, symptom distress, and symptom experience between the two groups over time and between groups(P<0.05). Conclusion: In order to prevent lymphedema among postoperative breast cancer patients, the "Internet+" nursing mode can play a significant role and has great potential for clinical application.

关 键 词：互联网+ 乳腺癌 淋巴水肿 护理 

分 类 号：R47[医药卫生—护理学]