手法淋巴引流联合药物治疗乳腺癌术后淋巴水肿的效果研究
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摘要
目的分析手法淋巴引流联合药物治疗乳腺癌术后淋巴水肿的效果。方法研究纳入2012年1月1日-2017年5月30日60例乳腺癌术后淋巴水肿患者,采用随机数字表法分为3组,A对照组采用药物治疗,B对照组采用单纯手法引流,观察组采用手法淋巴引流联合药物治疗,比较3组舒适度及生活质量改善方面、水肿消退指数等指标改善情况。结果 3组组内比较治疗前后双侧上臂周径差值差异显著,有统计学意义。A对照组、B对照组双侧上臂周径差值变化明显比观察组高。3组治疗前FACTB评分差异不显著,治疗后A对照组、B对照组评分均明显低于观察组,A对照组、B对照组差异不显著。观察组淋巴水肿改善情况优于A对照组、B对照组,有统计学显著差异。3组组内比较,治疗前后VAS差异显著,有统计学意义。A对照组、B对照组比观察组高。结论乳腺癌术后淋巴水肿患者采用地奥司明联合手动淋巴引流可降低疼痛、改善水肿程度,提高生存质量,值得临床推广与应用。
Objective To analyze the effect of lymphatic drainage in combination with drugs for the treatment of postoperative lymphedema of breast cancer. Methods The study period was from January 1st,2012 to May 30th,2017. A total of 60 subjects were enrolled in this study. All of them were patients with postoperative lymphedema of breast cancer and were divided into three groups by random number table. Drug treatment,control group B using simple drainage method,the treatment group using the method of lymphatic drainage combined with drug treatment,the three groups were compared comfort and quality of life improvement,edema regression index and other indicators to improve the situation. Results There was significant difference in the difference of the upper arm circumference between the two groups before and after nursing in the three groups. Control group A and control group B were higher than the observation group. Three groups before nursing FACTB score difference was not significant. After nursing,the score of control group A and control group B was lower than that of observation group,while there was no significant difference between control group A and control group B. The observation group improved lymphedema better than the control group A,control group B,the difference was significant,with statistical significance.Within the three groups,there was significant difference in VAS before and after nursing,with statistical significance.Control group A and control group B were higher than the observation group.Conclusions The combination of Diosmin and manual lymphatic drainage for patients with postoperative lymphedema of breast cancer could reduce the pain,improve the degree of edema and improve the quality of life,which deserved clinical application and promotion.
Objective To analyze the effect of lymphatic drainage in combination with drugs for the treatment of postoperative lymphedema of breast cancer. Methods The study period was from January 1st,2012 to May 30th,2017. A total of 60 subjects were enrolled in this study. All of them were patients with postoperative lymphedema of breast cancer and were divided into three groups by random number table. Drug treatment,control group B using simple drainage method,the treatment group using the method of lymphatic drainage combined with drug treatment,the three groups were compared comfort and quality of life improvement,edema regression index and other indicators to improve the situation. Results There was significant difference in the difference of the upper arm circumference between the two groups before and after nursing in the three groups. Control group A and control group B were higher than the observation group. Three groups before nursing FACTB score difference was not significant. After nursing,the score of control group A and control group B was lower than that of observation group,while there was no significant difference between control group A and control group B. The observation group improved lymphedema better than the control group A,control group B,the difference was significant,with statistical significance.Within the three groups,there was significant difference in VAS before and after nursing,with statistical significance.Control group A and control group B were higher than the observation group.Conclusions The combination of Diosmin and manual lymphatic drainage for patients with postoperative lymphedema of breast cancer could reduce the pain,improve the degree of edema and improve the quality of life,which deserved clinical application and promotion.
引文
[1] Park JH,Lee WH,Chung HS. Incidence and risk factors of breastcancerlymphoedenma[J].JClinNurs,2008,17(8):1450-1459.
[2]TaradajJ,HalskiT,RosinczukJ,etal.Theinfluenceof Kinesiology taping on the volume of lymphoedema and manual dexterityoftheupperlimbinwomenafterbreastcancer treatment[J].Eur J Cancer Care(Engl),2015,5(12):113-114.
[3]蔡亚运.乳腺癌术后上肢淋巴水肿的预防及护理新进展[C].上海市护理学会,第三届上海国际护理大会论文摘要汇编,2017,1.
[4]杜伟怡.预防及干预乳腺癌术后淋巴水肿的护理进展[C].上海市护理学会,第三届上海国际护理大会论文摘要汇编,2017,1.
[5]卜彩菊,庞永慧.乳腺癌术后患侧上肢水肿的预防护理进展[J].护理研究,2016,30(30):3716-3719.
[6]沈怡,强万敏,唐磊,等.乳腺癌术后重度上肢淋巴水肿患者延迟就诊原因的质性研究[J].护士进修杂志,2016,31(18):1699-1702.
[7]刘飞,路潜,欧阳倩,等.乳腺癌患者术后淋巴水肿与其相关症状的关系研究[J].中华护理杂志,2016,51(5):518-522.
[8]刘晓溪,王世宣.乳腺癌术后上肢淋巴水肿的发生因素分析与护理[J].护士进修杂志,2016,31(8):715-717.
[9]LopezPT,VanBodegravenJ,WinkensB,etal.Thequalityof life in longterm breast cancer survivors with breast cancer related lymphedema[J].Acta Chir Belg,2014,114(4):239-244.
[10]赵赛,孟繁洁.乳腺癌术后淋巴水肿的测量和评估研究现状[J].中华护理杂志,2013,48(6):558-561.
[11]殷萍.乳腺癌术后患肢水肿患者应用患肢加压与手法淋巴引流按摩的效果观察[J].护理学报,2012,19(14):53-54.
[12] Pavlista D,Eliska O. Analysis of direct oil contrast lymphography of upper limb lymphatics traversing the axilla-a lesson fromthepast-contributiontotheconceptofaxillaryreverse mapping[J].Eur J Surg Oncol,2012,38(5):390-394.
[13]陈如男,袁长蓉.乳腺癌术后上肢淋巴水肿的护理研究进展[J].护理研究,2012,26(14):1254-1256.
[14]麦慧英,蓝柳红,方永琴,等.带淋巴结游离皮瓣移植治疗乳腺癌术后淋巴水肿的围术期护理[J].护理学杂志,2012,27(8):23-24.
[15]SkolnyMN,MillerCL,O'TooleJ.Breastcancer-related lymphedema:modernmethodologyofassessmentand management[J].Breast Dis,2011,22(2):111-115.
[16]严梅,蒋妮,王雪芹,等.复合护理干预在乳腺癌术后淋巴水肿治疗效果的研究[J].护士进修杂志,2011,26(12):1109-1112.
[17]TaradajJ,HalskiT,RosinczukJ,etal.Theinfluenceof Kinesiology taping on the volume of lymphoedema and manual dexterityoftheupperlimbinwomenafterbreastcancer treatment[J].Eur J Cancer Care(Engl),2015,5(12):113-114.
[2]TaradajJ,HalskiT,RosinczukJ,etal.Theinfluenceof Kinesiology taping on the volume of lymphoedema and manual dexterityoftheupperlimbinwomenafterbreastcancer treatment[J].Eur J Cancer Care(Engl),2015,5(12):113-114.
[3]蔡亚运.乳腺癌术后上肢淋巴水肿的预防及护理新进展[C].上海市护理学会,第三届上海国际护理大会论文摘要汇编,2017,1.
[4]杜伟怡.预防及干预乳腺癌术后淋巴水肿的护理进展[C].上海市护理学会,第三届上海国际护理大会论文摘要汇编,2017,1.
[5]卜彩菊,庞永慧.乳腺癌术后患侧上肢水肿的预防护理进展[J].护理研究,2016,30(30):3716-3719.
[6]沈怡,强万敏,唐磊,等.乳腺癌术后重度上肢淋巴水肿患者延迟就诊原因的质性研究[J].护士进修杂志,2016,31(18):1699-1702.
[7]刘飞,路潜,欧阳倩,等.乳腺癌患者术后淋巴水肿与其相关症状的关系研究[J].中华护理杂志,2016,51(5):518-522.
[8]刘晓溪,王世宣.乳腺癌术后上肢淋巴水肿的发生因素分析与护理[J].护士进修杂志,2016,31(8):715-717.
[9]LopezPT,VanBodegravenJ,WinkensB,etal.Thequalityof life in longterm breast cancer survivors with breast cancer related lymphedema[J].Acta Chir Belg,2014,114(4):239-244.
[10]赵赛,孟繁洁.乳腺癌术后淋巴水肿的测量和评估研究现状[J].中华护理杂志,2013,48(6):558-561.
[11]殷萍.乳腺癌术后患肢水肿患者应用患肢加压与手法淋巴引流按摩的效果观察[J].护理学报,2012,19(14):53-54.
[12] Pavlista D,Eliska O. Analysis of direct oil contrast lymphography of upper limb lymphatics traversing the axilla-a lesson fromthepast-contributiontotheconceptofaxillaryreverse mapping[J].Eur J Surg Oncol,2012,38(5):390-394.
[13]陈如男,袁长蓉.乳腺癌术后上肢淋巴水肿的护理研究进展[J].护理研究,2012,26(14):1254-1256.
[14]麦慧英,蓝柳红,方永琴,等.带淋巴结游离皮瓣移植治疗乳腺癌术后淋巴水肿的围术期护理[J].护理学杂志,2012,27(8):23-24.
[15]SkolnyMN,MillerCL,O'TooleJ.Breastcancer-related lymphedema:modernmethodologyofassessmentand management[J].Breast Dis,2011,22(2):111-115.
[16]严梅,蒋妮,王雪芹,等.复合护理干预在乳腺癌术后淋巴水肿治疗效果的研究[J].护士进修杂志,2011,26(12):1109-1112.
[17]TaradajJ,HalskiT,RosinczukJ,etal.Theinfluenceof Kinesiology taping on the volume of lymphoedema and manual dexterityoftheupperlimbinwomenafterbreastcancer treatment[J].Eur J Cancer Care(Engl),2015,5(12):113-114.