手法引流综合消肿治疗在乳腺癌术后上肢淋巴水肿患者中的应用

摘要
图/表
参考文献(23)
相关文章 (15)

全文: PDF (787 KB) HTML (1 KB)
输出: BibTeX | EndNote (RIS)

摘要目的探讨乳腺癌术后上肢淋巴水肿治疗中手法引流综合消肿治疗的应用效果。方法选取中山大学肿瘤防治中心淋巴水肿门诊2017年1月至2018年1月乳腺癌改良根治术患者50例为对照组，进行常规护理；2019年1月至2020年1月乳腺癌改良根治术患者50例为观察组，对其进行有针对性的皮肤护理，给予其手法引流综合消肿治疗，包括专业化徒手引流淋巴、加压包扎过程中充分利用弹力绷带、督促患者进行患肢功能锻炼等。比较两组淋巴水肿情况及腋网综合征发生情况。结果两组淋巴水肿比例比较，差异有统计学意义（P ＜ 0.05）。观察组腋网综合征发生率低于对照组，差异有统计学意义（P ＜ 0.05）。结论手法引流综合消肿治疗能够有效地治疗乳腺癌改良根治术后出现的上肢淋巴水肿，无创、无痛苦、无副作用，可以降低腋网综合征的发生，值得推荐。

	服务

	把本文推荐给朋友
	加入我的书架
	加入引用管理器
	E-mail Alert
	RSS
	作者相关文章
	张慧珍张丽娟钟巧玲罗庆华张丽萍李月唐海林

关键词 ：乳腺癌, 改良根治术, 上肢淋巴水肿, 综合消肿治疗, 手法引流

Abstract：Objective To explore the application effect of manual drainage and comprehensive swelling treatment in the treatment of upper limb lymphedema after breast cancer surgery. Methods Fifty patients with modified radical mastectomy for breast cancer from January 2017 to January 2018 in the Lymphedema Clinic of Sun Yat-sen University Cancer Prevention and Treatment Center were selected as control group for routine care. From January 2019 to January 2020, a total of 50 patients with modified radical mastectomy for breast cancer were selected as observation group were given targeted skin care, and they were given manual drainage and comprehensive swelling treatment, including professional hand-held drainage of lymph, making full use of elastic bandages during compression bandaging, and urging patients to exercise the affected limbs. The lymphedema and the occurrence of axillary network syndrome were compared between the two groups. Results There was a statistically significant difference in the proportion of lymphedema between the two groups (P < 0.05). The incidence of axillary network syndrome in the observation group was lower than that in the control group, and the difference was statistically significant (P < 0.05). Conclusion Manipulative drainage and comprehensive swelling treatment can effectively treat upper limb lymphedema after modified radical mastectomy. It is non-invasive, painless, and has no side effects, and can reduce the occurrence of axillary network syndrome. It is worth recommending.

Key words： Breast cancer Improved radical surgery Upper limb lymphedema Comprehensive detumescence treatment Technique of drainage

基金资助:国家自然科学基金资助项目（81772961）；
广东省护理学会护理科研课题立项（gdhlxueh2019zx029）；
广东省医学科研基金资助项目（A2020267）。

通讯作者: 张丽娟（1979.10-），女，副主任护师；研究方向：乳腺癌围手术期护理、淋巴水肿综合消肿治疗。

引用本文:

张慧珍张丽娟钟巧玲罗庆华张丽萍李月唐海林. 手法引流综合消肿治疗在乳腺癌术后上肢淋巴水肿患者中的应用[J]. 中国医药导报, 2021, 18(22): 176-179.
ZHANG Huizhen ZHANG Lijuan ZHONG Qiaoling LUO Qinghua ZHANG Liping LI Yue TANG Hailin. Application of comprehensive swelling treatment with manual drainage in patients with upper limb lymphedema after breast cancer surgery. 中国医药导报, 2021, 18(22): 176-179.

链接本文:

https://www.yiyaodaobao.com.cn/CN/ 或 https://www.yiyaodaobao.com.cn/CN/Y2021/V18/I22/176

[1] 张航，杨文红.乳腺癌根治术后常见并发症原因分析[J].吉林医学，2010，31（29）：5105-5106.
[2] Torre LA，Bray F，Siegel RL，et al. Global cancer statistics，2012 [J]. CA Cancer J Clin，2015，65（2）：87-108.
[3] 刘媛媛，刘高明，胡进，等.1例高龄乳腺癌治疗后骨折诱发上肢重度淋巴水肿合并高血压患者的康复护理[J].当代护士：中旬刊，2020，27（4）：131-133.
[4] 舒晴，胡艳，栾春亮，等.体外冲击波治疗中重度乳腺癌相关淋巴水肿患者的疗效观察[J].中华物理医学与康复杂志，2020，42（2）：166-170.
[5] 吴蒙，王蓓，廖妍妍，等.单人简易手法引流在乳腺癌术后上肢淋巴水肿患者中的应用[J].中西医结合护理：中英文，2019，5（9）：102-106.
[6] Lee SH，Min YS，Park HY，et al. Health-related quality of life in breast cancer patients with lymphedema who survived more than one year after surgery [J]. J Breast Cancer，2012，15（4）：449-453.
[7] 李婷萱，胡元萍，李映兰.1例双乳癌并发双上肢淋巴水肿患者的治疗与护理[J].当代护士：下旬刊，2018，25（11）：154-156.
[8] Betty S，Benjamin SB，Nancy B，et al. Mechanosensitivity in the upper extremity following breast cancer treatment [J]. J Hand Ther，2014，27（1）：4-11.
[9] Meyha NS，Chantal MF，Nora KH，et al. Impact of adjuvant taxane-based chemotherapy on development of breast cancer-related lymphedema：results from a large prospective cohort [J]. Breast Cancer Res Treat，2015，151（2）：393-403.
[10] Elizabeth AC，Danielle R，Elena L，et al. Upper extremity disability and quality of life after breast cancer treatment in the Greater Plains Collaborative clinical research network [J]. Breast Cancer Res Treat，2019，175（3）：675-689.
[11] 张慧珍，张丽娟，钟巧玲，等.手法引流综合消肿治疗在乳腺癌术后上肢淋巴水肿患者中的应用[C].//中国抗癌协会.2019中国肿瘤学大会论文集，2019：7722-7722.
[12] Tessa CG，Hoda ES，Cheryl L. Brunelle，et al. Breast cancer-related lymphedema：risk factors，precautionary measures，and treatments [J]. Gland Surg，2018，7（4）：379-403.
[13] 马跃海，胡莹，李秋华，等.中药内服外治联合综合消肿治疗技术在中老年乳腺癌患者术后上肢淋巴水肿中的应用[J].实用药物与临床，2017，20（6）：627-630.
[14] 柏素萍，王静，周芳芳.综合消肿护理在乳腺癌患者术后淋巴水肿中的应用效果[J].中国保健营养，2017，27（29）：212-213.
[15] Cynthia LM，Amy SC，Nora H，et al. Immediate implant reconstruction is associated with a reduced risk of lymphedema compared to mastectomy alone：a prospective cohort study [J]. Ann Surg，2016，263（2）：399-405.
[16] Jeremy ST，Walter JJ，Swapna G，et al. Lymphaticovenous Bypass Decreases Pathologic Skin Changes in Upper Extremity Breast Cancer-Related Lymphedema [J]. Lymphat Res Biol，2015，13（1）：46-53.
[17] Devoogdt N，Christiaens MR，Geraerts I，et al. Effect of manual lymph drainage in addition to guidelines and exercise therapy on arm lymphedema related to breast cancer：randomised controlled trial [J]. BMJ，2011，343：d5326.
[18] Whitiker J，Williams A，Pope D，et al. Comparison of efficacy of the intermittent pneumatic compression with a high- and low-pressure applicaation in reducing the lower limbs phlebolymphedema [J]. J Wound Care，2015，24（3）：83-84，86-90，92-94.
[19] Kang Y，Jang DH，Jeon JY，et al. Pressure monitoring of multilayer inelastic bandaging and the effect of padding in breast cancer-related lymphedema patients [J]. Am J Phys Med Rehabil，2012，91（9）：768-773.
[20] Linda AK，David WH，Anne HB，et al. Function，Shoulder Motion，Pain，and Lymphedema in Breast Cancer With and Without Axillary Web Syndrome：An 18-Month Follow-Up [J]. Phys Ther，2018，98（6）：518-527.
[21] 李树林.乳腺肿瘤学[M].北京：科学技术文献出版社，2000：302-307.
[22] 童璐，张思义，曹战江.腋窝手术后腋网综合征的治疗及心理干预[J].湖北理工学院学报，2014，30（3）：57-59.
[23] 魏盘妹，苏逢锡.腋网综合征研究进展[J].中华乳腺病杂志：电子版，2012，6（6）：664-667.