乳腺癌患者淋巴水肿自我管理的证据总结

doi:10.3761/j.issn.0254-1769.2022.02.019

摘要/Abstract

摘要：

目的评价并总结乳腺癌患者淋巴水肿自我管理的相关证据,为临床医护人员指导患者进行自我管理,规范化评估患者自我管理状况提供依据。方法系统检索国内外相关指南网站、专业协会网站以及PubMed、Web of Science、Embase、CINAHL、中国知网、维普、万方等数据库中关于乳腺癌患者淋巴水肿自我管理相关指南、专家共识、最佳实践和推荐实践等,检索时限为2011年1月1日—2021年5月31日。由2名研究者独立进行文献质量评价和资料提取。结果共纳入24篇文献,其中指南7篇、专家共识6篇、最佳实践3篇、推荐实践8篇。从学习淋巴水肿相关知识、运动锻炼、保持健康体重、患肢保护、促进淋巴液回流、自我监测、心理调节、角色适应等8个方面汇总了28条最佳证据。结论该研究总结了乳腺癌患者淋巴水肿自我管理的最佳证据,可为临床医护人员规范患者自我管理指导,动态评估患者自我管理状况提供依据。

关键词: 乳腺肿瘤, 淋巴水肿, 自我管理, 循证护理学

Abstract:

Objective To retrieve,evaluate and summarize the best evidence of self-management of lymphedema of breast cancer patients’,and to provide references for education and evaluation of self-management of patients. Methods We searched relevant guideline networks and association websites,as well as PubMed,Web of Science,Embase,CINAHL,CNKI,VIP,Wanfang,CBM and other databases to collect relevant guidelines,expert consensuses,best practices and recommended practices related to self-management of lymphedema in breast cancer patients published from January 1,2011 to May 31,2021. 2 researchers evaluated the quality of various literature,and extracted relevant evidence from the included literature. Results A total of 24 articles were included,including 7 guidelines,6 expert consensuses,3 best practices and 8 recommended practices. Finally,28 pieces of best evidence including 8 dimensions were summarized,namely learning about lymphedema,exercise,maintaining a healthy weight,protecting the affected limb,promoting lymphatic circulation,self-monitoring,psychological adjustment and role adaptation. Conclusion This study summarized the best evidence of breast cancer patients’ self-management of lymphedema,which can provide references for medical staffs to conduct self-management guidance for patients and dynamically evaluate their self-management status,so as to effectively prevent or control lymphedema.

Key words: Breast Neoplasm, Lymphedema, Self-Management, Evidence-Based Nursing

韦小夏, 符鑫, 沈傲梅, 王玉洁, 张力川, 路潜. 乳腺癌患者淋巴水肿自我管理的证据总结[J]. 中华护理杂志, 2022, 57(2): 237-244.

WEI Xiaoxia, FU Xin, SHEN Aomei, WANG Yujie, ZHANG Lichuan, LU Qian. Evidence summary for self-management of lymphedema in breast cancer patients[J]. Chinese Journal of Nursing, 2022, 57(2): 237-244.

图/表 4

表1 纳入文献的基本特征（n=24）

Table 1 Characteristics of include articles（n=24）

表2 纳入指南的质量评价结果（n=7）

Table 2 Quality evaluation results of guidelines（n=7）

表3 纳入专家共识、最佳实践和推荐实践的质量评价结果（n=17）

Table 3 Quality evaluation results of expert consensus, best practices and recommended practices（n=17）

表4 乳腺癌患者淋巴水肿自我管理行为的最佳证据总结

Table 4 Evidence summary for lymphedema self-management behavior in breast cancer patients

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