乳腺癌相关淋巴水肿空气波压力治疗的最佳证据总结

doi:10.3761/j.issn.0254-1769.2022.11.016

摘要/Abstract

摘要：

目的总结乳腺癌相关淋巴水肿空气波压力治疗又称间歇充气加压（intermittent pneumatic compression,IPC）治疗的最佳证据,为临床开展IPC治疗提供指导。方法根据“6S”模型,系统检索国内外数据库中有关乳腺癌相关淋巴水肿IPC治疗的最佳实践、相关指南、证据总结、系统评价和专家共识等,检索时限截止至2021年10月。根据纳入和排除标准筛选文献,2名研究者独立对纳入的证据进行质量评价、证据提取和汇总。结果最终纳入16篇文献,其中指南5篇、证据总结1篇、系统评价7篇、专家共识3篇。提取了IPC治疗的适应证、禁忌证、治疗方案、治疗效果、治疗监测、注意事项共6个方面的25条最佳证据。结论 IPC可以作为乳腺癌相关淋巴水肿的治疗手段,治疗前应充分评估患者有无治疗的禁忌证,遵循推荐的治疗方案,治疗过程中注意监测潜在的并发症并做好预防。

关键词: 乳腺癌, 淋巴水肿, 乳腺癌相关淋巴水肿, 空气波压力, 间歇性充气加压, 护理

Abstract:

Objective To summarize the best evidence of intermittent pneumatic compression（IPC） therapy in patients with breast cancer-related lymphedema,and to provide references for clinical decision making. Methods According to “6S” model,we systematically searched the domestic and foreign databases to collect the evidence on IPC treatment for patients with breast cancer-related lymphedema,including guidelines,expert consensuses,systematic reviews,evidence summaries and recommended practice. The retrieval period was up to October 2021. The retrieved evidence was screened according to inclusion and exclusion criteria,and 2 researchers independently evaluated the quality of included literature,extracted and summarized the available information. Results A total of 16 articles were involved,including 5 guidelines,1 evidence summary,7 systematic reviews and 3 expert consensuses. 25 pieces of evidence were synthesized into 6 categories,including indications,contraindications,treatment programs,treatment effects,monitoring and points for attention during IPC treatment. Conclusion IPC can be used as an adjunctive therapy for breast cancer-related lymphedema. Contraindications should be fully evaluated before IPC treatment,and recommended treatment programs should be followed. Potential complications should be monitored and prevented during the treatment.

Key words: Breast Cancer, Lymphedema, Breast Cancer-Related Lymphedema（BCRL）, Air Wave Pressure, Intermittent Pneumatic Compression（IPC）, Nursing Care

王玲, 王海燕, 王婷婷, 周丽华, 王惠雪, 虞苗. 乳腺癌相关淋巴水肿空气波压力治疗的最佳证据总结[J]. 中华护理杂志, 2022, 57(11): 1384-1390.

WANG Ling, WANG Haiyan, WANG Tingting, ZHOU Lihua, WANG Huixue, YU Miao. Best evidence summary for intermittent pneumatic compression in treatment of patients with breast cancer-related lymphedema[J]. Chinese Journal of Nursing, 2022, 57(11): 1384-1390.

图/表 4

表1 纳入文献的基本信息（n=16）

Table 1 Characteristics of included studies（n=16）

表2 纳入指南的方法学质量评价结果（n=5）

Table 2 Quality evaluation results of guidelines（n=5）

表3 纳入系统评价的质量评价结果（n=7）

Table 3 Quality evaluation results of systematic review（n=7）

表4 乳腺癌相关淋巴水肿空气波压力治疗的最佳证据总结

Table 4 Evidence summary for intermittent pneumatic compression in treatment of patients with breast cancer-related lymphedema

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