左乳腺癌伴腋窝淋巴结转移患者癌性伤口的护理  

Experience of nursing care of cancer wound healing in patients with left breast cancer and axillary lymph node metastasis

作　　者：曹兆铭 王迎春 CAO Zhao-ming;WANG Ying-chun(School of nursing,Jinzhou Medical University,Jinzhou 1210ol,China;Department of oncology,the First Afiliated Hospital of Jinzhou Medical University,Jinzhou 121000,China)

机构地区：[1]锦州医科大学护理学院,辽宁锦州121001 [2]锦州医科大学附属第一医院肿瘤内科一病区,辽宁锦州121000

出　　处：《临床皮肤科杂志》2023年第1期33-35,共3页Journal of Clinical Dermatology

摘　　要：报告1例左乳腺癌伴腋窝淋巴结转移患者癌性伤口的护理经验。患者女,55岁。左乳出现一大量粘稠脓性渗出伴有恶臭的伤口2个月,皮肤科检查:左侧乳腺乳头下内、外象限可见一10 cm×11.5 cm×3 cm肿物,破溃,近圆形,伤口表面覆盖黄白色腐肉和脓苔,大量黄褐色粘稠渗出液(患者所穿衣物被浸透)伴有恶臭,腋窝可触及多发肿大的淋巴结,融合成团,边界不清,质地韧,无压痛,活动度差。免疫组化:雌激素受体(ER)(阳性率<1%),人表皮生长因子受体2(HER-2)(+++),P53(阳性率约20%),细胞增殖标记Ki-67(阳性率约40%)。诊断:左乳浸润性癌HER-2扩增型cT4N2aM0Ⅲ期腋窝淋巴结转。The experience of nursing care for a patient with left breast cancer and axillary lymph node metastasis is summarized. The patient was 55 years old female, present with malodorous wound with large amount of viscous purulent exudation in the left breast for 2 months. Dermatologic examination revealed a tumor measuring 10 cm×11.5 cm×3 cm, located in the inner and outer quadrants under the left breast nipple. The tumor is ulcerated, nearly rounded. The wound was covered with yellowish-white pus moss, and a large amount of yellowish-brown viscous exudate(the clothes worn by the patient are soaked)with stench. Multiple enlarged lymph nodes could be touched in the armpit, fused into clusters, with unclear boundary, tough,no tenderness, and poor mobility. Immunohistochemistry demonstrated that ER(positive rate<1%), HER-2(3+), P53(+, positive rate about 20%), Ki-67(40%). The patient was diagnosed as invasive carcinoma of left breast, with HER-2 amplified c T4N2aM0 Ⅲ axillary lymph node metastasis.

关 键 词：恶性肿瘤 癌性伤口 评估三角 护理 

分 类 号：R739.5[医药卫生—肿瘤]