摘要
目的探讨加压弹力绷带对改善乳腺癌患者术后上肢淋巴水肿的效果。方法采用自身对照的类实验性研究,选择2016年5-6月在复旦大学附属肿瘤医院接受手术治疗后出现上肢淋巴水肿的9例患者。所有患者给予密集治疗期、随访维持期2个阶段的加压弹力绷带应用,密集治疗期由淋巴水肿治疗师实施加压弹力绷带的包扎,为期12 d;6个月的随访维持期,以患者在家进行弹力绷带加压包扎为主,分别在2个阶段测量患者患侧上肢手臂周径的和生存质量。结果患者在密集治疗期各测量点的患侧手臂周径随着治疗的进展都在逐渐减少(P<0.05),随访期3个月时,手掌、肘部和肘上10 cm的周径较最近的一次治疗时有所增加(P<0.05),而在随访期6个月时,从手掌到肘上10 cm各测量点的周径较随访3个月时都有所增加(P<0.05)。患者的角色功能、情绪功能、社会功能、系统治疗不良反应和上肢症状在密集治疗前后的得分有所下降(P<0.05)。随访期,社会功能、系统治疗不良反应和上肢症状的得分呈治疗期下降、随访期反而上升的趋势,且具有统计学差异(P<0.05)。结论加压弹力绷带可以在由淋巴水肿治疗师主导的密集治疗期改善乳腺癌患者上肢淋巴水肿,提高患者的角色功能、情绪功能和社会功能方面的生存质量。但是加压弹力绷带的复杂操作不利于患者的自我照护,随访期缺失专业人员的督促和协助造成患者依从性降低,导致淋巴水肿的效果反弹。
Objective To explore the effect of compression elastic bandage on improving upper limb lymphedema in postoperative patients with breast cancer. Methods 9 patients with upper limb lymphedema after surgery in Fudan University Shanghai Cancer Hospital from May to June 2016 were selected by conducting a self-controlled quasi-experimental study. All patients received compression elastic bandage application in the intensive treatment phase and follow-up maintenance phase. Compression wrapping with elastic bandages was performed by a lymphedema therapist for 12 days in the intensive treatment phase, and performed by the patients themselves at home in the 6-month follow-up maintenance phase. The arm circumference and quality of life of patients were measured for the 2 phases. Results The circumference of the affected arm at each measuring site in the intensive treatment phase decreased gradually with the progress of treatment(P<0.05). At the 3 months of the follow-up phase, the circumferences of the palm, elbow and 10 cm above the elbow increased compared with those at the latest treatment(P<0.05), while at the 6 months of the follow-up phase, the circumference of each measuring site,from the palm to 10 cm above the elbow, increased compared with those at the 3 months(P<0.05). The scores in role functioning, emotional functioning, social functioning, side effects of systemic therapy and upper limb symptoms decreased after intensive treatment(P<0.05). The scores in social functioning, side effects of systemic therapy and upper limb symptoms showed a decreasing trend in the treatment phase yet an increasing trend in the follow-up phase,with statistical significance(P <0.05). Conclusion Compression elastic bandage can improve upper limb lymphedema of breast cancer patients in the intensive treatment phase led by the lymphedema therapist, and improve the quality of life of patients in terms of role functioning, emotional functioning and social functioning. However, the complicated operation of the compression elastic bandage is not conducive to patient selfcare. The lack of supervision by and assistance from professionals in the follow-up phase leads to a decrease in patient compliance and a rebound in lymphedema.
作者
裘佳佳
李平
QIU Jiajia;LI Ping(Fudan University Shanghai Cancer Hospital,Department of Oncology at Shanghai Medical College of Fudan University,Shanghai 200032,China)
出处
《上海护理》
2019年第9期34-38,共5页
Shanghai Nursing
基金
复旦大学护理科研基金项目(FNF201535)
关键词
乳腺癌
上肢淋巴水肿
加压弹力绷带
生存质量
Breast cancer
Upper limb lymphedema
Compression elastic bandage
Quality of life
