妇科恶性肿瘤手术患者下肢淋巴水肿非药物预防措施的最佳证据总结  

Non-pharmacological preventive measures for lower limb lymphedema in surgical patients with gynecologic malignancy:a best evidence summary

作　　者：吴言 杜琼靓 王佳 刘畅 伊焕英 蒙莉萍 郭洪花 Wu Yan;Du Qiongliang;Wang Jia;Liu Chang;Yi Huanying;Meng Liping;Guo Honghua(International School of Nursing,Hainan Medical University,Haikou 570000,Hainan Province,China;Department of Nursing Administration,the First Affiliated Hospital of Hainan Medical University,Haikou 570000,Hainan Province,China)

机构地区：[1]海南医科大学国际护理学院,海南海口570000 [2]海南医科大学第一附属医院护理部,海南海口570000

出　　处：《现代临床护理》2025年第2期10-22,共13页Modern Clinical Nursing

基　　金：2023年海南省自然科学基金青年基金项目,项目编号为823QN248;2023年海南省级研究生创新课题,项目编号为Qhys2023-481。

摘　　要：目的评价总结妇科恶性肿瘤手术患者下肢淋巴水肿非药物预防措施的最佳证据,为临床预防下肢淋巴水肿提供循证依据。方法系统检索Up To Date,BMJ Best Practice,英国国家医疗保健优化研究所(National Institute for Health and Care Excellence,NICE),肿瘤学护理学会(Oncology Nursing Society,ONS),国际指南协作网(Guidelines International Network,GIN),中国临床指南文库,医脉通,美国国立综合癌症网络(National Comprehensive Cancer Network,NCCN),加拿大安大略注册护士协会(Registered Nurses Association of Ontario,RNAO),美国肿瘤协会(American Society of Clinical Oncology,ASCO),欧洲临床肿瘤协会(European Society for Medical Oncology,ESMO),澳大利亚癌症协会(Cancer Australia,CA),国际淋巴水肿网站(National Lymphedema Network,NLN),苏格兰校际指南网(Scottish Intercollegiate Guidelines Network,SIGN),淋巴水肿支持网络(Lymphedema Support Network,LSN),国际淋巴学会(International Society of Lymphology,ISL),国际癌症护理护士协会(International Society of Nurses In Cancer Care),安大略省淋巴水肿协会(Lymphedema Association of Ontario),淋巴水肿联盟(Lymphoedema United),Cochrane Library,Web of Science,PubMed,Scopus,OVID,Embase,CINAHL,维普,万方,中国知网,中国生物医学文献数据库中关于妇科恶性肿瘤患者下肢淋巴水肿非药物预防措施的相关证据并评价,检索时限为建库至2024年1月31日。由2名研究员对临床决策、专家共识、系统评价进行质量评价,4名研究者对指南进行质量评价,最终由2名研究者进行资料提取以及证据汇总。结果共纳入17篇文献,包括2篇临床决策、2篇指南、2篇系统评价、7篇专家共识、1篇证据总结、3篇随机对照试验(randomized controlled trial,RCT)。汇总了预防时机、评估要素、一般自我护理、皮肤护理、手法淋巴引流、压力疗法、运动、健康教育8个方面共32条证据。结论本研究可为临床医护人员制�Objective To evaluate and summarise the best evidence on non-pharmacological preventive measures for lower limb lymphedema in patients with gynecologic malignancy so as to provide an evidence-based guidance for prevention of lower limb lymphedema.Methods Systematic searches were conducted from inception to 31th January,2024 on databases of UpToDate,BMJ Best Practice,the National Institute for Health and Care Excellence(NICE),the Oncology Nursing Society(ONS),Guidelines International Network(GIN),China Guideline Clearinghouse,Medlive,National Comprehensive Cancer Network(NCCN),Registered Nurses Association of Ontario(RNAO),American Society of Clinical Oncology(ASCO),European Society for Medical Oncology(ESMO),Cancer Australia(CA),National Lymphedema Network(NLN),Scottish Intercollegiate Guidelines Network(SIGN),Lymphedema Support Network(LSN),International Society of Lymphology(ISL),International Society of Nurses in Cancer Care,Lymphedema Association of Ontario,Lymphoedema United,Cochrane Library,Web of Science,PubMed,Scopus,OVID,Embase,CINAHL,VIP,Wangfang Data,CNKI and SinoMed for the relevant evidence in non-pharmacological preventive measures for lower limb lymphedema in patients with gynecological malignancy.Two researchers evaluated the quality of clinical decisions,expert consensus,systematic reviews and randomised controlled trials,while four investigators assessed the quality of the guidelines.Another two researchers performed data extraction and evidence summary.Results A total of 17 articles were included,comprising two clinical decisions,two guidelines,two systematic reviews,seven expert consensuses,one evidence summary,three randomised controlled trials.A total of 32 pieces of evidence were summarised across eight dimensions:prevention timing,evaluation element,general self-care,skin care,manual lymphatic drainage,compression therapy,exercise and health education.Conclusion This study provides an evidence-based guidance for prevention of lower limb lymphedema in patients with gynecological malignancy.

关 键 词：肿瘤 妇科学 下肢淋巴水肿 预防 证据总结 循证护理 

分 类 号：R473.71[医药卫生—护理学] R473.73[医药卫生—临床医学]