基于降低风险方案的管理路径对预防宫颈癌术后淋巴水肿效果的研究  

Prevention of lymphedema after cervical cancer surgery using a management pathway based on risk reduction protocols

作　　者：赵文芳 高俊 付颖 ZHAO Wenfang;GAO Jun;FU Ying(Department of Gynecology,Subei People's Hospital Affiliated to Yangzhou University,Yangzhou 225002,China)

机构地区：[1]扬州大学附属苏北人民医院妇科,江苏扬州225002

出　　处：《医药高职教育与现代护理》2025年第2期152-155,共4页Medical Higher Vocational Education and Modern Nursing

摘　　要：目的 探讨基于降低风险方案管理路径对预防宫颈癌术后淋巴水肿发生的效果。方法 将2022年6月至2023年7月江苏省苏北人民医院妇科收治的65例宫颈癌术后放化疗患者按随机数字表法随机分为对照组(32例)和研究组(33例)。对照组采用常规护理,研究组采用降低风险方案的淋巴水肿预防管理路径进行护理。分别于放化疗前、放化疗后1、3、6个月观察患者双下肢周径变化,采用妇科癌症淋巴水肿问卷分别对比两组患者放化疗前、放化疗6个月下肢淋巴水肿自感症状和发生率情况。结果 两组患者放化疗前和放化疗1、3个月双下肢周径数值对比差异无统计学意义(P>0.05),放化疗6个月研究组患者双下肢周径小于对照组(P<0.05);放化疗前两组患者淋巴水肿自感症状、淋巴水肿发生率对比差异无统计学意义(P>0.05),放化疗6个月研究组患者下肢淋巴水肿自觉症状及淋巴水肿发生率低于对照组(P<0.05)。结论 基于降低风险方案的管理路径可减轻宫颈癌术后放化疗患者淋巴水肿相关症状,能有效预防淋巴水肿的发生,但远期效果尚需进一步观察。Objective To explore the effectiveness of risk-reductionbased management pathway in preventing lymphedema after cervical cancer surgery.Methods From June 2022 to July 2023,65 patients undergoing postoperative radiotherapy and chemotherapy for cervical cancer at Subei People's Hospital Affiliated to Yangzhou University were randomly divided into a control group(n=32) and a study group(n=33) using a random number table.The control group received routine nursing care,while the study group was treated with lymphedema prevention and management pathway based on a risk-reduction program.Changes in the circumference of both lower limbs were observed before,one,three and six months after chemoradiation.The Gynecologic Cancer Lymphedema Questionnaire(GCLQ) was used to compare the self-perceived symptoms and incidence of lower limb lymphedema between the two groups before and six months after chemoradiation.ResultsThere was no significant difference between the two groups before chemoradiation,one month and three months after chemoradiation(P>0.05).However,at six months,the circumference of both lower limbs in the study group was smaller than the control group(P<0.05).There was no significant difference in self-perceived lymphedema symptoms and the incidence of lymphedema between the two groups before radiotherapy and chemotherapy(P>0.05).The self-perceived symptoms of lymphedema and the incidence of lymphedema in the study group after six months of chemoradiotherapy were lower than those in the control group(P<0.05).Conclusions The management pathway based on the risk-reduction plan can alleviate lymphedema-related symptoms in patients undergoing postoperative radiotherapy and chemotherapy for cervical cancer,and can effectively prevent the occurrence of lymphedema.However,the long-term effects on the occurrence of lymphedema needs further observation.

关 键 词：风险方案 预防 路径 宫颈癌术后 淋巴水肿 

分 类 号：R73[医药卫生—肿瘤]