摘要
目的探讨基于降低风险方案的乳腺癌淋巴水肿预防管理路径对乳腺癌术后淋巴水肿发生情况及症状体验的影响。 方法基于降低风险方案设计乳腺癌淋巴水肿预防管理路径,采用便利抽样法选取60例乳腺癌腋窝淋巴结清扫术后患者,按随机数字表法随机分为干预组29例和对照组31例。对照组接受常规护理,干预组按乳腺癌淋巴水肿预防管理路径进行管理。术后1、3、6、12个月时采用上臂连续周径测量法及乳腺癌相关淋巴水肿症状体验指数量表对患者进行测评。 结果术后12个月时,干预组的淋巴水肿相关症状个数为4.00(8.00)个,对照组为9.00(7.00)个,组间差异具有统计学意义(Z=-2.023,P=0.043);干预组的淋巴水肿相关症状困扰得分为3.00(7.00)分,对照组为7.00(17.00)分,组间比较差异有统计学意义(Z=-2.159,P=0.031),其中,干预组功能维度及性维度得分分别为0(2.00)、0(0)分,对照组功能维度及性维度得分分别为3.00(5.00)、0(1.00)分,差异均有统计学意义(Z=-2.315、-2.334,P=0.021、0.020)。干预组淋巴水肿发生率低于对照组,但组间比较差异无统计学意义(P>0.05)。 结论基于降低风险方案的乳腺癌淋巴水肿预防管理路径可减少患者的淋巴水肿相关症状,减轻症状困扰,改善患者的淋巴水肿相关症状体验,对淋巴水肿发生率的影响尚需更长时间的随访和观察。
ObjectiveTo explore the effect of preventive management path of breast cancer related lymphedema based on risk reduction program on breast cancer patients underwent axillary lymph nodes dissection (ALND).MethodsThis study used convenient sampling method to recruit 60 patients underwent ALND. Patients were randomly divided into the control group (n=31) and the intervention group(n=29). All patients received general care while patients of the intervention group also received the Risk Reduction Program. Lymphedema symptom experience was investigated by Breast Cancer and Lymphedema Symptom Experience Index 1 month, 3 months, 6 months, 12 months after surgery.ResultsTwelve months after surgery, the intervention group had 4.00 (8.00) lymphedema related symptoms while the controll group had 9.00 (7.00) , the difference was significant (Z=-2.023, P=0.043). The score of lymphedema related symptom distress in the intervention group was 3.00 (7.00) while it was 7.00 (17.00) in the control group, the difference was significant (Z=-2.159, P=0.031). The scores of functional dimension and sexual dimension in the intervention group were 0 (2.00) and 0 (0) , and in the control group were 3.00 (5.00) and 0 (1.00) , the differences were significant (Z=-2.315,-2.334, P=0.021,0.020). No significant differences of lymphedema rate existed between groups (P>0.05).ConclusionThe preventive management path of breast cancer related lymphedema based on risk reduction program can decrease the number of lymphedema symptoms and release lymphedema symptom distress.
作者
刘飞
路潜
王影新
史双
李春月
Liu Fei;Lu Qian;Wang Yingxin;Shi Shuang;Li Chunyue(Surgical Department,Peking University First Hospital,Beijing 100034,China;Peking University School of Nursing,Beijing 100191,China;Cardial Surgery Department,Peking University First Hospital,Beijing 100034,China;Ward One,Peking-University Sixth Hospital,Beijing 100191,China)
出处
《中国实用护理杂志》
2019年第7期530-535,共6页
Chinese Journal of Practical Nursing
基金
北京大学医学部护理科研基金项目(BMU20160517).
关键词
乳腺肿瘤
淋巴水肿
路径
症状
症状困扰
干预
Breast neoplasm
Lymphedema
Path
Symptom
Symptom distress
Intervention
