戴金梅

【摘要】 目的：探讨综合性护理在乳腺癌术后预防上肢淋巴水肿中的作用。方法：选取笔者所在医院2017年6月-2019年6月收治的女性乳腺癌手术患者86例，采用随机数字表法分为两组，每组43例。对照组采取常规护理干预，研究组在此基础上实施综合性护理，为期6个月。比较两组上肢淋巴水肿发生率及生存质量。结果：研究组上肢淋巴水肿发生率为6.98%，低于对照组的25.58%，差异有统计学意义（P<0.05）;两组术前生存质量测定量表（FACT-B）评分比较，差异无统计学意义（P>0.05）;两组术后6个月的FACT-B评分均高于术前，且研究组的评分为（113.53±12.68）分，高于对照组的（102.78±10.25）分，差异有统计学意义（P<0.05）。结论：综合性护理能够有效预防乳腺癌术后上肢淋巴水肿，改善患者生存质量。

【关键词】 乳腺癌 综合性护理 上肢淋巴水肿 生存质量

doi：10.14033/j.cnki.cfmr.2020.20.041 文献标识码 B 文章编号 1674-6805（2020）20-0-03

Observation of the Effect of Comprehensive Nursing on the Prevention of Upper Limb Lymphedema after Breast Cancer Surgery/DAI Jinmei. //Chinese and Foreign Medical Research， 2020， 18（20）： -105

[Abstract] Objective： To explore the effect of comprehensive nursing in preventing upper limb lymphedema after breast cancer surgery. Method： A total of 86 female breast cancer patients treated in our hospital from June 2017 to June 2019 were selected and divided into two groups by random number table. The control group took routine nursing intervention， and the research group implemented comprehensive nursing on this basis for 6 months. The incidence of upper limb lymphedema and quality of life were compared between the two groups. Result： The incidence of upper limb lymphedema in the study group was 6.98%， which was lower than 25.58% in the control group， the difference was statistically significant （P<0.05）. There was no difference in the preoperative Functional Assessment of Cancer Therapy （FACT-B） scores between the two groups， there was no significant difference （P>0.05）. The FACT-B score of the study group at 6 months after operation was （113.53±12.68） points， which was higher than （102.78±10.25） points of the control group， the difference was statistically significant （P<0.05）. Conclusion： Comprehensive nursing can effectively prevent upper limb lymphedema after breast cancer surgery and improve the quality of life of patients.

[Key words] Breast cancer Comprehensive nursing Upper limb lymphedema Quality of life

First-authors address： Longyan First Hospital Affiliated to Fujian Medical University， Longyan 364000， China

乳腺癌是常見肿瘤疾病，主要发病人群为女性，及时接受外科手术治疗在控制病情发展中意义重大[1]。乳腺癌外科手术包括乳腺及腋窝淋巴结两部分，腋窝淋巴结清扫术是治疗乳腺癌的常用术式，可预防乳腺癌转移，控制病情[2]。但腋窝淋巴结清扫术造成的局部软组织粘连、淋巴管及小血管减少，会使局部淋巴液及静脉血回流障碍，导致上肢淋巴水肿，影响患者预后，术后需加强护理干预[3]。综合性护理是一种全面的护理干预模式，可提升工作的计划性及主动性，在预防手术并发症中效果显著[4]。本研究旨在探讨综合性护理对预防乳腺癌术后上肢淋巴水肿的应用价值，现将结果示下。

1 资料与方法

1.1 一般资料

选取笔者所在医院2017年6月-2019年6月收治的女性乳腺癌手术患者86例，符合文献[5]《中国抗癌协会乳腺癌诊治指南与规范》的诊断标准;均行腋窝淋巴清扫治疗;意识清醒，无认知、语言、听力、精神障碍及脏腑器官疾病;采用随机数字表法分为两组，每组43例。……