乳腺癌术后手背部Ⅲ级淋巴水肿行多层绷带联合施耐德包扎效果探讨  

Effect of multi-layer bandaging combined with Schneider bandaging of gradeⅢlymphedema on the back of the hand after breast cancer surgery

作　　者：钟巧玲[1] 张慧珍[1] 罗庆华 张惠婷[1] 张丽萍 刘凤 张丽娟[1] 唐海林[1] Zhong Qiaoling;Zhang Huizhen;Luo Qinghua;Zhang Huiting;Zhang Liping;Liu Feng;Zhang Lijuan;Tang Hailin(Cancer Prevention and Management Center,Sun Yatsen University,Guangzhou 510060,China)

机构地区：[1]中山大学肿瘤防治中心,广东广州510060

出　　处：《护理学杂志》2020年第19期38-41,共4页Journal of Nursing Science

基　　金：国家自然科学基金面上项目(81772961);2018年广东省护理学会护理科研立项面上项目(gdhlxueh2019zx029);2020年广东省医学科研基金项目(A2020267)。

摘　　要：目的促进乳腺癌术后患侧手背部Ⅲ级淋巴水肿患者淋巴回流,减轻局部症状与病理改变。方法将来我院淋巴水肿门诊就诊的86例乳腺癌术后患侧上肢Ⅲ级淋巴水肿患者按就诊时间段分为常规组44例、改进组42例。常规组行常规多层绷带从指端到肩下加压包扎;改进组采用多层绷带联合施耐德包扎法。每天1次,连续20次后评价效果。结果改进组患侧手掌周径减小程度显著优于常规组(均P<0.01),紧绷感、麻木感、肿胀感发生率显著低于常规组(P<0.05,P<0.01)。结论多层绷带联合施耐德包扎法可有效促进淋巴回流,有利于恢复肢体形状,缓解主观症状。Objective To activate lymphatic circulation in patients with gradeⅢlymphedema of the back of the hand of the operated side following breast cancer surgery,and to relieve symptoms and pathological changes.Methods A total of 86 breast cancer patients with gradeⅢlymphedema of the upper limb were chronologically divided into a routine group of 44 and a modified group of 42.The routine group received conventional multi-layer bandaging alone from the finger to the shoulder,while the modified group was subjected to multi-layer bandaging in combination with Schneider bandaging once a day.The effect was evaluated after 20-day intervention.Results The modified group showed significantly decreased circumference of the affected hand,lower rates of tightness,numbness,and swelling compared with the routine group(P<0.05,P<0.01).Conclusion Multi-layer bandaging combined with Schneider bandaging can effectively activate lymphatic circulation,thus to restore the shape of the limbs and relieve subjective symptoms.

关 键 词：乳腺癌 手术后 患侧上肢 手背部 Ⅲ级淋巴水肿 综合消肿治疗 绷带加压包扎 施耐德包扎 

分 类 号：R473.2[医药卫生—护理学]