摘要
背景:乳腺癌术后患者的患侧肢体由于组织结构创伤破坏严重,常可导致功能活动障碍,直接影响生活和工作。目的:通过3阶段功能锻炼培训及健康指导,促进乳腺癌术后患者患侧上肢功能恢复。设计:临床观察。单位:中国医科大学附属第一医院护理部。对象:以2002-05/2004-05在中国医科大学附属第一医院确诊为乳腺癌并已接受手术治疗的患者168例为观察对象。患者均为女性;年龄34～72岁,平均49.65岁。方法:对乳腺癌术后患者进行患侧上肢自护培训:①术后卧床期(手术后第1,2天):进行手腕、肘部的主动活动和被动活动的培训,2～3次/d,15～20min/次。②下床活动期(手术后第3～14天):进行肩关节活动的培训,3～4次/d,15～20min/次。③出院后(3～6个月):上肢功能锻炼指导培训,2～3次/d,15～20min/次。通过复诊进行患者自护培训效果的调查,患者自护培训后每2个月复诊1次。主要观察指标:①乳腺癌术后患者患侧上肢功能恢复情况及自护情况。②坚持患侧上肢功能锻炼情况及有无异常。结果:168例患者均进入结果分析。①患者患侧上肢功能恢复90.0%(151/168),并能从事简单工作和家务;患者能在日常生活中时刻注意患侧上肢的自我保护65.0%(109/168)。②患者能将出院后的上肢功能训练坚持半年以上75.0%(126/168);患者曾出现过不同程度的患侧上肢淋巴水肿25.0%(42/168)。结论:加强对乳腺癌术后患者患侧上肢功能锻炼的培训,告知患者及家属坚持上肢锻炼的实际意义及掌握自我保护的要领,患侧上肢功能恢复效果理想。
BACKGROUND：The tissue structure of the affected arms of the breast cancer patients is seriously damaged after operation, which often causes the disorder of functional activity and directly affects the lives and work of Breast Cancer patients. OBJECTIVE： To promote the functional recovery of affected-side upperlimb in patients with breast cancer after operation by three-stage functional training and health guidance. DESIGN： Clinical observation SETTING： Department of Nursing, First Affiliated Hospital, China Medical University PARTICIPANTS：Totally 168 patients,to be all female,aged from34 to 72 years with the average of 49.65 years,diagnosed breast cancer and received operation in the First Affiliated Hospital of the China Medical University from May 2002 to May 2004, were recruited. METHODS：Self-training was performed on the upper-arm at the affected side in patients after breast cancer operation ： ① On-bed stage after operation （ one or two days after operation）： Do active and passive exercises of their wrists and elbows, 2-3 times per day , 15 to 20 minutes per time. ② Off-bed stage （3 to 14 days after operation）： Do exercises of shoulder joint, 3 to 4 times per day, 15 to 20 minutes per time. ③Discharging from the hospital（ 3 to 6 months）, functional exercise and guidance training on the upper arm, 2 to 3 times per day , 15 to 20 minutes per time. Self-training effect of the patients was investigated through further consultation, every 2 months after the self-training. MAIN OUTCOME MEASURES： ① Functional recovery status and the self nursing status of their affected arms of the patients. ② functional exercises status and the abnormal status of their affected arms of the patients. RESULTS ：Totally 168 patients completed the study, all their date was entered the final result analysis. ①90.0% （151/168）of the patients had got a better recovery with their affected arms and could do some simple work and household duties; ②65.0% （109/168）of the patients could pay more attention to the protection of their affected arms in their daily lives; ③ 75.0% （126/168）of the patients persisted in the functional training of their affected arms over half a year after they discharged from the hospital; 25.0% （42/168）of the patients had different degrees of lymphatic edema of the affected arms. CONCLUSION：We have got an obvious effect in the aspects of strengthening the guidance of the functional training of their affected arms of the breast cancer patients and telling the patients and their family members the significance of persisting in training their main points of self nursing of their affected arms.
出处
《中国临床康复》
CSCD
北大核心
2005年第38期146-147,共2页
Chinese Journal of Clinical Rehabilitation
