下肢加压疗法预防乳腺癌患者化疗致周围神经病变的效果研究

doi:10.3761/j.issn.0254-1769.2026.01.011

摘要/Abstract

摘要：

目的探讨下肢加压疗法预防乳腺癌患者化疗致周围神经病变的效果，为临床护理实践提供有效的非药物干预策略。方法采用便利抽样法，于2023年2月—2024年1月选取在四川省南充市某三级甲等医院乳腺甲状腺外科住院的84例接受含白蛋白结合型紫杉醇化疗方案的乳腺癌患者作为研究对象，采用随机数字表法，将其分为试验组和对照组，每组各42例。试验组在每次化疗前30 min至化疗结束后30 min穿戴医用梯度压力袜，对照组接受常规护理，试验干预贯穿所有化疗周期。分别于每次化疗前及末次化疗后1个月，检测足掌触觉，评价患者的下肢感觉与运动损伤严重程度和平衡功能。结果试验组39例、对照组37例完成研究。试验组足掌触觉障碍发生率低于对照组，差异具有统计学意义（P<0.001），且症状中位出现时间延迟（P<0.001）。广义估计方程分析显示，试验组的感觉损伤程度轻于对照组，时间与组别的交互效应具有统计学意义（P=0.008）。此外，化疗结束后1个月，对照组的平衡功能下降（P<0.05）。结论下肢加压疗法可延缓白蛋白结合型紫杉醇致周围神经病变的发生进展并减轻其严重程度，对维持患者化疗期间的平衡功能也有一定的效果。

关键词: 加压疗法, 化疗致周围神经病变, 乳腺癌, 白蛋白结合型紫杉醇, 护理

Abstract:

Objective To evaluate the effectiveness of lower limb compression therapy in preventing chemotherapy-induced peripheral neuropathy（CIPN） among breast cancer patients，aiming to provide clinical nursing practice with an effective non-pharmacological intervention strategy. Methods Using convenience sampling，84 breast cancer patients hospitalized in the Department of Breast and Thyroid Surgery of a tertiary grade A hospital in Nanchong City，Sichuan Province，between February 2023 and January 2024，who were receiving a chemotherapy containing nab-paclitaxel，were selected as study subjects. They were divided into an experimental group（n=42） and a control group（n=42） using a simple randomization method. Patients in the experimental group wore graduated compression stockings at 30 minutes prior to each chemotherapy session until 30 minutes after cessation of the chemotherapy. The control group received routine care. The experimental intervention was applied to all chemotherapy cycles. Plantar tactile sensation was assessed before each chemotherapy session and after the last chemotherapy session to evaluate the patients’ lower extremity peripheral nerve injury and balance function. These assessments were performed before each chemotherapy cycle and after the final cycle. Results 39 patients in the experimental group and 37 in the control group completed the study. The incidence of plantar tactile impairment was significantly lower in the experimental group than that in the control group（P<0.001）. The median time to symptom onset was also delayed in the experimental group（P<0.001）. Generalized Estimating Equation analysis showed a significant interaction between time and group for sensory scores（P=0.008），indicating a less severe sensory damage in the experimental group. At 1 month after the final chemotherapy cycle，the balance function declined in the control group，with success rates in the Four-Stage Balance Test or Timed Up and Go test decreasing by approximately 18.9%（P<0.05）. Conclusion Lower extremity compression therapy delayed the onset and progression of nab-paclitaxel-induced peripheral neuropathy，reduced its severity，and helped maintain the balance function during chemotherapy.

Key words: Compression Therapy, Chemotherapy-Induced Peripheral Neuropathy, Breast Cancer, Nab-Paclitaxel, Nursing Care

彭媛, 杨正伟, 何川, 陈玉琴. 下肢加压疗法预防乳腺癌患者化疗致周围神经病变的效果研究[J]. 中华护理杂志, 2026, 61(1): 78-84.

PENG Yuan, YANG Zhengwei, HE Chuan, CHEN Yuqin. Effectiveness of lower limb compression therapy in preventing chemotherapy-induced peripheral neuropathy in breast cancer patients[J]. Chinese Journal of Nursing, 2026, 61(1): 78-84.

图/表 3

表1 两组一般资料的比较

Table 1 Comparison of general baseline data between the 2 groups

表2 两组神经毒性问卷感觉评分的比较[分，M（P25，P75）]

Table 2 Comparison of Patient Neurotoxicity Questionnaire（PNQ） sensory scores between the 2 groups[scores，M（P25，P75）]

表3 两组神经毒性问卷运动评分的比较[分，M（P25，P75）]

Table 3 Comparison of Patient Neurotoxicity Questionnaire（PNQ） motor scores between the 2 groups[scores，M（P25，P75）]

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