乳腺癌相关淋巴水肿患者压力治疗的证据总结

Evidence summary of compression therapy in patients with breast cancer-related lymphedema

目的检索、评价并总结国内外关于乳腺癌相关淋巴水肿患者压力治疗的最佳证据,为临床医护人员对乳腺癌相关淋巴水肿患者采取压力治疗提供参考。方法使用PIPOST工具明确循证问题,设置检索策略以及纳入和排除标准,系统检索国内外常见数据库中关于乳腺癌相关淋巴水肿患者压力治疗方面的指南、专家共识、证据总结、推荐实践、系统评价等证据,检索时间为建库至2021年12月,由2名研究者独立对文献进行质量评价和资料提取。结果共纳入13篇文献,其中指南2篇,专家共识3篇,推荐实践1篇,临床决策2篇,证据总结3篇,系统评价2篇。最终从压力治疗禁忌证、治疗前评估、治疗方案以及健康教育4个方面总结了27条最佳证据。结论本研究证据总结可为临床医护人员开展乳腺癌相关淋巴水肿压力治疗提供依据和参考。在临床实际应用时,需要充分考虑特定临床情景中相关措施的可及性,并结合医护人员的判断及患者的意愿及经济状况等因素,审慎地将证据应用于临床实践中。

Objective To retrieve,evaluate and summarize the best evidence of compression therapy for breast cancer-related lymphedema patients at home and abroad,and provide reference for clinical medical staff to take pressure therapy for breast cancer-related lymphedema patients.Methods The PIPOST tool was used to clarify the evidence-based questions,set the search strategy and inclusion and exclusion criteria.The guideline,expert consensus,evidence summary,recommended practice,systematic review and other evidence on compression therapy of breast cancer-related lymphedema patients were systematically searched in common databases at home and abroad.The retrieval time was from the establishment of the database to December 2021.Two researchers independently evaluated the quality of the literature and extracted the data.Results A total of 13 articles were included,including 2 guidelines,3 expert consensus,1 recommended practice,2 clinical decision making,3 evidence summaries and 2 systematic reviews.Finally,27 pieces of best evidence were summarized from four aspects,such as contraindications of stress treatment,pre-treatment evaluation,treatment plan and health education.Conclusions The summary of evidence in this study can provide a basis and reference for clinical medical staff to carry out the compression therapy of breast cancer-related lymphedema.In clinical practice,it is necessary to fully consider the availability of relevant measures in specific clinical scenarios and to prudently apply evidence to clinical practice in combination with the judgment of medical staff,wishes of patients and economic conditions.