乳腺癌术后患者患肢水肿的护理干预

Prophylactic interventions for postoperative edema of the upper limb following breast cancer surgery

目的探讨乳腺癌患者行腋窝淋巴结清扫术后患肢水肿的护理策略及效果。方法按入院时间将腋窝淋巴结清扫术后乳腺癌患者进行分组。对照组(122例)实施常规护理;改进组(125例)在常规护理的基础上,对患肢肿胀实施预见性护理,包括有氧患肢训练、渐进性放松疗法以及穴位按摩,应对术后初期出现的患肢血液循环障碍相关肿胀;借助压力治疗仪、手法淋巴引流、瘢痕护理应对潜在淋巴泵衰竭导致的早期淋巴水肿问题。结果改进组术后1、3、6个月患肢水肿发生率显著低于对照组(P<0.05,P<0.01)。结论针对患肢水肿的护理干预能降低乳腺癌术后患肢水肿发生率。

Objective To explore effective nursing strategy for prevention of edema of the upper limb following axillary lymph node dissection in breast cancer patients and to evaluate the effect. Methods Patients with breast cancer undergoing axillary lymph node dissection were sequentially divided into two groups. The control group of 122 patients received routine nursing care, while the modified group of 125 patients were given prophylaxis against postoperative edema, including aerobic upper limb exercise, progres- sive relaxation exercise and acupoint massage to prevent swelling induced by circulatory disturbances in early postoperative period, as well as compression therapy with equipment, manual lymph drainage, and scar care to deal with early lymphedema caused by im- paired lymphatic pumping. Results The incidence of swelling of the upper limb in the modified group was significantly lower than that in the control group at postoperative 1, 3 and 6 month （P〈0.05, P〈0.01）. Conclusion Prophylactic intervention can reduce postoperative swelling of the upper limb in breast cancer patients.