Abstract:

This article reports successful nursing experience in lymphedema relief by adopting the modified complex decongestion therapy for a patient after cervical cancer surgery,who was suffering postoperative stage Ⅲ lymphedema of both lower extremity combined with stage Ⅱ lymphedema of the lower abdomen and vulvar. The main points of care during treatment include skin care,prevention and reduction of infection;the improved manual lymphatic drainage combined with air wave pressure therapy can promote lymphatic fluid directional flow. Various methods are used for pressure dressing to maintain the effect of detumescence. Individual diet and exercise management plan was formulated for scientific weight loss. Maintenance nursing includes self-lymph drainage exercise combined with Kegel training to improve exercise compliance,and multi-disciplinary follow-up management to stimulate patient self-care potential. After 9 months of careful treatment and nursing,the circumference of each part of the patient’s lower extremities decreased by 2.0~14.2 cm;the swelling sense of the lower abdomen and perineum disappeared;the BMI decreased to normal.

Key words: Cervical Cancer, Lymphedema, Complex Decongestion Therapy, Rehabilitation Nursing

摘要：

总结1例宫颈癌术后双下肢Ⅲ期合并下腹部及外阴部Ⅱ期淋巴水肿患者进行改良式综合消肿治疗的护理经验。治疗期护理要点包括进行皮肤护理,预防和减少感染;改良手法淋巴引流联合空气波压力治疗仪,促进淋巴液定向流动;采用多种方法进行压力包扎,维持消肿效果;制订个体化的饮食及运动管理方案,科学减重。维持期护理要点包括结合凯格尔训练编制自我淋巴引流操,提高锻炼依从性;多学科协作进行随访管理,激发患者自我照护潜能。经过9个月的精心治疗及护理,患者双下肢各部位周径缩小了2.0~14.2 cm,下腹部及会阴部肿胀感消失,BMI降至正常水平。

关键词: 宫颈癌, 淋巴水肿, 综合消肿治疗, 康复护理