综合消肿护理及不同化疗方案对乳腺癌患者淋巴水肿的影响

Effects of comprehensive detumescence nursing and different chemotherapy regimens on lymphedema in breast cancer pa-tients

目的探讨综合消肿护理及不同化疗方案对乳腺癌患者淋巴水肿的影响.方法选取420例接受新辅助化疗的乳腺癌患者作为研究对象,采用抽签法抽取30例患者给予综合消肿护理.比较不同治疗方案和护理方法患者淋巴水肿发生率及发生时间,分析淋巴水肿发生的影响因素.结果 本组患者术后2 a淋巴水肿发生率为17.4%,紫杉烷化疗患者更易发生淋巴水肿,紫杉烷化疗患者手术至淋巴水肿发生时间显著短于基于蒽环类化疗及联合化疗患者(P<0.01),紫杉烷化疗患者术后2 a淋巴水肿发生率显著高于基于蒽环类化疗患者(P<0.05).综合消肿护理患者手术至淋巴水肿发生时间显著长于未接受综合消肿护理患者(P<0.01),综合消肿护理患者术后2 a淋巴水肿发生率显著低于未接受综合消肿护理患者(P<0.05).肥胖、腋窝淋巴结清扫、紫衫烷化疗是淋巴水肿的独立危险因素(P<0.05),综合消肿护理是独立保护因素(P<0.05).结论紫杉烷新辅助化疗患者更易发生淋巴水肿,综合消肿护理是缓解淋巴水肿的有效护理方法.

Objective To analyze the effects comprehensive detumescence nursing and different chemo­therapy regimens on lymphedema in breast cancer patients.Methods A total of 420 breast cancer patients received neoadjuvant chemotherapy were enrolled in the study.30 patients received CDT were drawn ac­cording to the lottery method.Compare the incidence and time of lymphedema in patients with different treatment options and nursing methods.Analyze the influencing factors of lymphedema.Results 2 years after operation,the incidence of lymphedema was 17.4%,and patients with taxane chemotherapy were more prone to lymphedema.The time from surgery to lymphedema in patients with taxane chemotherapy was significantly shorter than that based on anthracycline chemotherapy and combination chemotherapy(P<0.01),the incidence of lymphedema was significantly higher in patients with taxane chemotherapy 2 years after surgery than in patients based on anthracycline chemotherapy(P<0.05).The time from oper­ation to lymphedema in patients with CDT was significantly longer than that in patients who did not re­ceive CDT(P<0.01).The incidence of lymphedema in CDT patients after 2 years was significantly lower than that in patients who did not receive CDT(P<0.05).Obesity,axillary lymph node dissection,and taxane chemotherapy were independent risk factors for lymphedema(P<0.05),and CDT was an inde­pendent protective factor(F<0.05).Conclusions Patients with neoadjuvant chemotherapy of taxane are more prone to lymphedema.CDT is an effective nursing method to relieve lymphedema.