摘要
目的探讨乳腺癌化疗患者经外周静脉穿刺中心静脉置管(PICC)后上肢水肿的原因和护理对策。方法选择2012年1月—2016年12月医院收治的乳腺患者84例,根据随访结果分为研究组(发生上肢水肿)22例和对照组(未发生上肢水肿)62例。统计患者一般资料、诊断结果、手术情况,采用Logistic回归分析确定PICC置管后上肢水肿的独立危险因素。结果单因素分析结果显示,研究组年龄20~40岁、淋巴结转移、临床分期为Ⅱ~Ⅲ期、腋窝处理为淋巴结清扫、肿块直径>5 cm、有术后愈合并发症、淋巴结清扫数目≥10个、术侧肢体活动过度的患者比例显著高于对照组(P<0.05或P<0.01)。Logistic回归分析显示,年龄、淋巴结清扫、术侧肢体活动过度、术后愈合并发症均是导致PICC置管后上肢水肿的独立危险因素。结论年龄、淋巴结清扫、术侧肢体活动过度、术后愈合并发症是导致PICC置管后患者上肢水肿的独立危险因素,应针对上述因素开展针对性护理干预,改善患者化疗期间生活质量。
Objective To investigate the potential risk factors and related nursing measures ofupper extremity edema in breast cancer patients undergoing chemotherapy via peripherally insertedcentral catheter(PI CC)line.Methods Totally84patients with breast cancer were given chemotherapyvia PI CC line.Patients were assigned to the study group(n=22,with upper extremityedema)and the control group(n=62,without upper extremity edema)according to the follow-up result.The general information,clinical outcomes and surgery conditions were retrospectivelyanalyzed.The independent factors of upper extremity edema after PI CCcatheterization were investigatedby using logistic regression.Results The proportion of patients aged>40yrs,withlymphatic metastasis,with stage II]0breast cancer,receiving lymphadenectomy,lumps size>5cm,with postoperative complication,with dissected lymph-node number"10,with excessivelimb movement were higher in the study group than that of controls(P<0.05or P<0.01).The Logistic regression analysis indicated that age over40yrs,receiving lymphadenectomy,withexcessive limb movement and with postoperative complication were independent factors of upperextremity edemaafter PI CC catheterization.Conclusion Age,lymphadenectomy,excessivelimb exercise and postoperative complication are related to the upper extremity edema catheterization.Targeted nursing interventions on such issues should be carried out to improve thequality of life in breast cancer patients undergoing chemotherapy via PI CC line.
作者
徐欢欢
韦立梅
XU Huanhuan;WEI Limei(Department of Oncological Hematology,Shuyang People's Hospital,Shuyang,Jiangsu,223600)
出处
《中西医结合护理（中英文）》
2017年第5期57-59,共3页
Journal of Clinical Nursing in Practice
关键词
乳腺癌
化疗
经外周静脉穿刺中心静脉置管
上肢水肿
护理对策
breast cancer
chemotherapy
peripherally inserted central catheter
upper extremity edema
nursing countermeasure
