以伤口专科护士为主导的链式管理路径在乳腺癌患者癌性伤口中的应用

Application effects of chain management pathway led by specialist nurses in breast cancer wounds

目的 :分析以伤口专科护士为主导的链式管理路径在乳腺癌患者癌性伤口管理中的应用效果,为乳腺癌患者癌性伤口的早期干预和全程管理提供参考依据。方法 :成立由护理部、伤口专科门诊和相关科室组成的乳腺癌患者癌性伤口链式管理团队,以伤口专科护士为主导,依托伤口护理门诊随访系统,多科室联动,链接乳腺癌患者围手术期、加强治疗期到居家护理期全过程,从早筛查、早诊断、早干预、持续随访4个环节对癌性伤口高风险乳腺癌患者进行链式管理。结果 :2019年5月至2022年5月,共收治4 300例乳腺癌患者,共筛查出925例癌性伤口高风险患者,高风险患者中有115例(12.4%)已发生癌性伤口。实施癌性伤口链式管理前后,癌性伤口患者的恶性肿瘤伤口评估总分分别为(196.23±3.11)分和(67.28±6.17)分。实施前后各期疼痛平均得分分别为(8.23±1.10)分和(2.12±0.61)分,渗液量平均得分分别为(22.35±3.26)分和(11.21±4.63)分。实施后患者的平均满意度为95.8%。结论 :以伤口专科护士为主导的乳腺癌患者癌性伤口链式管理路径有利于癌性伤口症状的早期控制,减缓伤口进展。

Objective:To explore the application effects of chain management pathway led by wound specialist nurses in the management of breast cancer wounds.Methods:A chain management team of breast cancer wounds led by wound specialist nurses were composed by Nursing Department,Wound Care Clinic and other related departments.Malignant Fungating Wounds(MFWs)Chain management was carried out for patients with high-risk breast cancer wounds from four aspects of early screening,early diagnosis,early intervention and continuous follow-up.Results:Since May 2019 to May 2022,4300 patients with breast cancer were enrolled,including 925 patients with high-risk breast cancer wounds and 115 patients with cancer wounds.Before and after the implementation of breast cancer wound chain management,the total scores of patients with breast cancer wound were(196.23±3.11)and(67.28±6.17)respectively.The average pain scores of each stage before and after implementation were(8.23±1.10)and(2.12±0.61)respectively,the average scores of exudate volume were(22.35±3.26)and(11.21±4.63)respectively.The average satisfaction of patients after implementation was 95.84%.Conclusion:The chain management pathway led by wound specialist nurses in the management of breast cancer wounds is benefcial to early control of wound symptoms,which can enhance the quality of life of the patients.