乳腺癌改良根治術后上肢淋巴水腫預防行為干預遠期效果評價

陳芳 堵麗麗 李娜

【摘 要】目的：探討對具有上肢淋巴水腫高危發病因素的乳腺癌根治術后患者實施系列預防行為干預措施對其遠期效果的影響。方法：選取2016年1月至2018年10月本院外科44例行改良根治術的具有上肢淋巴水腫高危發病因素的乳腺癌患者，隨機分為對照組和觀察組各22例。對照組給予外科術后常規護理，觀察組在常規護理基礎上實施針對上肢淋巴水腫并發癥的術后系列預防行為干預措施。跟蹤隨訪1年，對比兩組術后1個月、3個月、6個月、1年的上肢淋巴水腫發生率的差異和患者日常生活活動能力情況。結果：術后1個月，兩組患者上肢淋巴水腫發生率比較無明顯差異，無統計學意義（P>0.05）;術后3個月、6個月及1年，兩組患者上肢淋巴水腫發生率存在明顯差異，觀察組術后3個月、6個月及1年的上肢淋巴水腫發生率均明顯低于對照組。出院隨訪3個月、6個月和1年，觀察組BI得分均明顯高于對照組，差異均有統計學意義（P<0.05）。結論：對具有上肢淋巴水腫高危發病因素的改良根治術后的乳腺癌患者實施系列預防行為干預措施，可明顯預防和減少患者上肢淋巴水腫的發生，提高患者日常生活活動能力，對患者遠期治療效果具有非常重要的臨床意義。

【關鍵詞】乳腺癌;改良根治術;上肢淋巴水腫;預防行為干預;遠期效果

文章編號：WHR2019045018

[Abstract] Objective：To explore the effect of a series of preventive behavior interventions on the long-term effects of patients with radical mastectomy for upper extremity lymphedema. Methods： From January 2016 to October 2018， 44 patients with breast cancer who had high-risk factors of upper limb lymphedema were treated with modified radical mastectomy in our hospital. They were randomly divided into control group and observation group. The control group received routine postoperative care， and the observation group performed postoperative series of preventive behavioral interventions for upper limb lymphedema complications on the basis of routine care. The follow-up was performed for 1 year. The difference of the incidence of upper limb lymphedema and the activities of daily living activities of the two groups were compared between 1 month， 3 months and 6 months to 1 year. Results： At 1 month after operation， there was no significant difference in the incidence of upper limb lymphedema between the two groups （P>0.05）. The incidence of upper limb lymphedema in the two groups was 3 months， 6 months and 1 year after operation. There were significant differences. The incidence of upper limb lymphedema was significantly lower in the observation group than in the control group at 3 months， 6 months and 1 year after operation. After 3 months， 6 months and 1 year of follow-up， the scores of BI in the observation group were significantly higher than those in the control group， and the differences were statistically significant （P<0.05）. Conclusion： A series of preventive behavioral interventions for patients with breast cancer after modified radical mastectomy with high risk of upper limb lymphedema can significantly prevent and reduce the occurrence of lymphedema in the upper limbs of patients， improve the ability of patients to daily activities， and have long-term therapeutic effects on patients. Very important clinical significance.