手法淋巴引流护理缓解乳腺癌术后患者淋巴水肿与腋网综合征的效果分析

Analysis of the Effect of Manual Lymphatic Drainage Care in Relieving Lymphedema and Axillary Web Syndrome in Postoperative Breast Cancer Patients

目的:探讨使用手法淋巴引流护理对缓解乳腺癌术后患者淋巴水肿与腋网综合征(AWS)的应用效果。方法:选取2020年3月—2021年9月河南省人民医院收治的80例乳腺癌患者作为研究对象,随机分为对照组和观察组,每组各40例。两组患者均行乳腺癌改良根治术治疗,对照组采用常规护理,观察组采用手法淋巴引流护理。比较两组患者淋巴结水肿度、AWS发生率、疼痛度评分、生存质量评分、双侧上臂周径差值。结果:观察组轻度淋巴结水肿度明显高于对照组,差异有统计学意义(χ^(2)=4.091,P<0.05)。观察组AWS发生率明显低于对照组,差异有统计学意义(χ^(2)=5.600、4.804,P<0.05)。治疗前,两组患者NRS评分比较,差异无统计学意义(t=3.252,P>0.05);治疗后,观察组疼痛数字评分法(NRS)评分明显低于对照组,差异有统计学意义(t=4.254,P<0.05)。治疗前,两组患者生存质量测定量表(FACT-B)各维度评分比较,差异无统计学意义(t=0.542、0.856、0.535、0.253,P>0.05);治疗后,观察组FACT-B量表各维度评分高于对照组,差异有统计学意义(t=6.456、8.236、6.685、8.254,P<0.05)。治疗前,两组患者双侧上臂周径差值比较,差异无统计学意义(t=2.415,P>0.05);治疗后,观察组双侧上臂周径差值低于对照组,差异有统计学意义(t=7.568,P<0.05)。结论:在缓解乳腺癌术后患者淋巴水肿与AWS中使用手法淋巴引流护理,有助于减轻患者的淋巴结水肿度,降低AWS发生率,缓解患者疼痛感,提升患者生存质量,降低双侧上臂周径差值。

Objective:To observe the nursing effect of manipulative lymphatic drainage in alleviating lymphedema and axillary web syndrome(AWS)in patients with postoperative breast cancer.Methods:80 cases of breast cancer patients admitted to the hos⁃pital from March 2020 to September 2021 were selected as study subjects and randomly divided into control and observation groups,with 40 cases in each group.Patients in both groups were treated with modified radical mastectomy for breast cancer,and the control group was treated with conventional care while the observation group was treated with lymphatic drainage care.The degree of lymph node edema,incidence of AWS,pain score,quality of survival score,and bilateral upper arm circumference difference were compared between the two groups.Results:The degree of mild lymph node edema in the observation group was significantly higher than that in the control group,and the difference was statistically significant(χ^(2)=4.091,P<0.05).The inci⁃dence of AWS in the observation group was significantly lower than that in the control group,and the difference was statistically significant(χ^(2)=5.600,4.804,P<0.05).Before treatment,there was no statistically significant difference between the NRS scores of the two groups(t=3.252,P>0.05).After treatment,the NRS score of the observation group was significantly lower than that of the control group,and the difference was statistically significant(t=4.254,P<0.05).Before treatment,there was no statistically signifi⁃cant difference in the scores of each dimension of the FACT-B scale between the two groups(t=0.542,0.856,0.535,0.253,P>0.05).After treatment,the FACT-B scale scores for each dimension were higher in the observation group than in the control group,with statistically significant differences(t=6.456,8.236,6.685,8.254,P<0.05).Before treatment,there was no statistically signifi⁃cant difference between the two groups in terms of bilateral upper arm circumference(t=2.415,P>0.05).After treatment,the difference of bilateral upper arm circumference in the observation group was lower than that in the control group,and the difference was statistically significant(t=7.568,P<0.05).Conclusion:The use of manual lymphatic drainage care in relieving lymphedema and AWS in postoperative breast cancer patients helps to reduce the degree of lymph node edema,decrease the incidence of AWS,relieve patients’pain,improve their quality of survival,and reduce the bilateral upper arm circumference difference.