腋下衬垫在预防老年乳腺癌病人医用粘胶相关性皮肤损伤及术后早期功能锻炼中的应用效果  

Application of underarm pad in prevention of medical adhesive-related skin injury and early postoperative functional exercises in elderly patients with breast cancer

作　　者：许丹丹 周峥[1] 周利 王丽[1] 刘莉[1] XU Dan-dan;ZHOU Zheng;ZHOU Li;WANG Li;LIU Li(Department of Breast Surgery,Drum Tower Hospital Affiliated to Nanjing University Medical College,Nanjing 210008,China)

机构地区：[1]南京大学医学院附属鼓楼医院江北国际医院乳腺外科,江苏省南京市210008

出　　处：《实用老年医学》2023年第9期964-967,共4页Practical Geriatrics

摘　　要：目的设计并制作乳腺自粘压力绷带腋下衬垫,探讨其在老年乳腺癌病人中预防医用粘胶相关性皮肤损伤及术后早期功能锻炼中的应用效果。方法选取2020年7月至2021年3月于南京鼓楼医院乳腺外科行乳腺癌改良根治术的老年病人80例,分为衬垫组37例,对照组43例,衬垫组在自粘压力绷带与腋下交界处使用自行设计的衬垫,对照组常规使用自粘压力绷带。比较2组腋下皮肤医用粘胶相关性皮肤损伤发生率、早期功能锻炼依从性及伤口疼痛评分情况。结果衬垫组3例(8.1%)病人发生医用粘胶相关性皮肤损伤,对照组11例(25.6%)病人发生医用粘胶相关性皮肤损伤(χ^(2)=4.206,P=0.04);在术后早期功能锻炼方面,衬垫组19例(51.4%)病人锻炼频次多于3次/d,对照组仅7例(16.3%)病人锻炼频次多于3次/d(χ^(2)=11.151,P=0.001);衬垫组29例(78.4%)病人锻炼舒适度良好,对照组仅6例(14.0%)病人锻炼舒适度良好(χ^(2)=33.542,P<0.001);此外,衬垫组中位伤口疼痛评分为1(0,2)分,对照组中位伤口疼痛评分为3(2,4)分(Z=7.106,P<0.001)。结论乳腺自粘压力绷带腋下衬垫的使用可减少老年乳腺癌病人腋下部位医用粘胶相关性皮肤损伤的发生率,提高早期功能锻炼的依从性,并在一定程度上减少病人伤口疼痛。Objective To design an underarm pad used with breast pressure bandage,and to explore its application effect on preventing medical adhesive-related skin injury and early postoperative functional exercises in the elderly patients with breast cancer.Methods A total of 80 elderly patients who underwent modified radical mastectomy for breast cancer in Drum Tower Hospital from July 2020 to March 2021 were enrolled and divided into the pad group(n=37)and the control group(n=43).The pad group used self-designed underarm pad at the junction of self-adhesive pressure bandage and axilla,while the control group used self-adhesive pressure bandage routinely.The incidence rate of medical adhesive-related skin injury,early functional exercise compliance and wound pain score of the two groups were compared.Results Skin injury occurred in 3 patients(8.1%)in the pad group,and in 11 patients(25.6%)in the control group(χ^(2)=4.206,P=0.04).In terms of early postoperative functional exercise,19 patients(51.4%)in the pad group exercised for more than 3 times per day,only 7 patients(16.3%)in the control group exercised for more than 3 times per day(χ^(2)=11.151,P=0.001).And 29 patients(78.4%)in the pad group felt comfortable during exercise,and only 6 patients(14.0%)in the control group felt comfortable during exercise(χ^(2)=33.542,P<0.001).The median wound pain score of the pad group was 1(0,2)points,while the median wound pain score of the control group was 3(2,4)points(Z=7.106,P<0.001).Conclusions The use of underarm pad combined with breast self-adhesive pressure bandage can reduce the occurrence of medical adhesive-related skin injury in the underarm area of the elderly patients with breast cancer,improve the compliance with early functional exercises,and reduce the wound pain to a certain extent.

关 键 词：医用粘胶相关性皮肤损伤 乳腺癌 护理 功能锻炼 疼痛 

分 类 号：R473.6[医药卫生—护理学]