加速康复外科护理对宫颈癌行腹腔镜下子宫广泛切除术患者术后康复水平的影响研究

目的：分析加速康复外科护理理念应用于宫颈癌行腹腔镜下子宫广泛切除术患者围术期中的临床效果。方法将90例宫颈癌行腹腔镜下子宫广泛切除术患者,随机分为FTS组和对照组各45例。对照组患者行常规护理,FTS组患者在常规护理的基础上加入加速康复外科护理理念。分析对比两组患者术后康复情况。结果 FTS组患者首次下床活动时间、首次排气时间、排便时间、术后平均住院时间、平均住院费用均少于对照组,差异有统计学意义（P﹤0.01）。FTS组并发症发生率低于对照组,差异有统计学意义（P﹤0.05）。结论加速康复护理理念应用于宫颈癌行腹腔镜下子宫广泛切除术患者,有利于患者康复,缩短患者术后恢复时间,减少平均住院费用,并且降低患者并发症发生率。     

机械性肠道准备对胃癌患者术后影响的相关研究

目的 研究肠道准备对胃癌患者术后的影响,探讨胃癌患者术前肠道准备的必要性.方法 选取胃癌患者66例,按照数字抽签法将患者随机分为机械性肠道准备(MBP)组(n=35)和非MBP组(n=31).比较两组患者术前血清白蛋白水平和日常生活能力评分、手术指标及不良反应发生情况.结果 MBP组与非MBP组患者的术前血清白蛋白水平、术前日常生活能力评分、腹壁切口长度、手术时间、术中出血量、术中腹腔冲洗液用量、术后排便时间比较,差异均无统计学意义(P>0.05);MBP组患者的术后排气时间、引流管留置时间明显短于非MBP组患者(P<0.01),住院费用明显低于非MBP组患者(P<0.01);两组患者腹腔引流液细菌培养阳性、吻合口瘘和切口感染的发生率比较,差异无统计学意义(P>0.05);MBP组患者的术后发热(>38.5℃),术后抗生素再使用,梗阻性腹胀、腹痛和术后予以辅助排便的发生率明显低于非MBP组(P<0.01).结论 术前适度肠道准备有利于术后快速康复,能使医患共同获益.     

进展期胃癌腹腔镜辅助与开放D2根治术围手术期临床效果比较

目的:比较腹腔镜辅助与开放D2胃癌根治术手术、病理与术后恢复情况。方法:回顾性分析我科收治的202例胃癌患者。查阅电子病历系统,收集腹腔镜与开放胃癌根治术患者的病历资料,比较腹腔镜组和开放组手术时间、术中出血量、淋巴结清扫数目、术后并发症与术后恢复等相关指标。结果:与开放组相比,腹腔镜组术中出血量少［（90.63±78.66）vs (154.15±151.65)ml,P<0.001］,淋巴结清扫数目相当［(21.4±10.5) vs (21.7±11.4)个,P=0.810］,术后伤口脂肪液化发生少,术后通气时间早［（3.0±0.8）vs (3.5±1.0)天,P<0.001］,术后进半流食时间早［（6.2±1.5）vs （6.8±2.3）天,P=0.028］,术后住院时间短［（9.4±2.3）vs （11.3±3.0）天,P=0.022］,仅手术时间稍长［（222±36）vs（205±62）min,P=0.021］。结论:在进展期胃癌D2根治术中,虽然腹腔镜手术时间略长于开放组,总体而言,腹腔镜组能达到与开放手术相同的淋巴结清扫数目,且具有术中出血量少,术后恢复快的优势。     

超声电导仪促进妇科良性肿瘤术后患者胃肠功能的恢复

目的:探讨超声电导仪对妇科术后患者胃肠功能恢复的影响。方法:选取2017年1月至6月中国医科大学附属盛京医院第一妇科病房收治的妇科良性手术患者180例,因腹腔镜及开腹排气时间有差异,将入选病例分为2组,其中良性开腹手术96例,良性腹腔镜手术84例。将2组病例随机分为两组,对照组及治疗组。对照组实施常规治疗及早期康复锻炼。治疗组在实施对照组同样治疗的基础上予超声药物透入治疗,从术后开始,每天2次,每次30 min。疗程至患者肛门排气为止。比较两组患者术后肠鸣音恢复时间、第一次排气时间及第一次排便时间。结果:无论开腹手术,还是腹腔镜手术,应用超声电导仪组的患者术后肠鸣音恢复时间、第一次排气时间及第一次排便时间较对照组均明显缩短,差异有统计学意义,（P＜0.05）。结论:妇科良性手术术后患者应用超声电导仪能有效地促进患者术后胃肠功能的恢复,且安全、方便、无创、无痛,患者依从性好,有利于患者术后早期康复,符合快速康复理念,值得推广。     

快速康复外科在大于60岁老年胃癌患者中的适用性分析

目的:探讨快速康复外科（fast track surger,FTS）在青年与老年胃癌患者中的安全性。 方法:回顾性分析我院2009年1月至2013年9月采用快速康复策略的胃癌患者,分析比较青年与老年患者术后康复过程以及术后并发症出现的差异。 结果:两组患者在年龄与合并疾病以及麻醉评分上具有明显差异性（P<0.05）,其他一般资料均无明显差异性（P>0.05）。术后康复过程中首次排气、排便与进食时间、术后尿管的拔出时间、抗生素使用时间、术后住院时间以及患者住院花费老年组略高于青年组,但两组之间的差异性无统计学意义（P>0.05）。老年组与青年组在术后并发症包括吻合口漏、肺炎、切口感染、泌尿系感染、深静脉血栓形成、肠梗阻的发生上并无明显差异性（P>0.05）;而老年组再次入院率较青年组较高,差异具有统计学意义（P<0.05）。结论:与青年胃癌患者相比,年龄≥60岁的老年胃癌患者在快速康复策略实施过程中具有相同的安全性与有效性。     

早期肠内营养在结肠癌术后恢复中的作用研究

目的 探讨早期肠内营养在结肠癌手术患者中的临床应用.方法 将结肠癌患者90例按数字表法随机分为肠内营养组、留置胃管组及对照组,每组30例.对照组常规治疗,留置胃管组给予术后间断夹闭胃管并给予肠内营养,肠内营养组术后早期给予拔除胃管同时给予肠内营养.观察术后排气、排便时间、术后住院时间及营养学指标.结果 术后三组之间排气时间、排便时间、术后住院时间差异有统计学意义[肠内营养组：（50.07±11.59）h、（76.75±27.37）h、（10.11±1.57）d;对照组：（62.03±12.31）h、（90.67±25.64）h、（11.80±1.83）d;留置胃管组：（43.53±11.94）h、（61.17±22.67）h、（8.70±1.53）d;均P＜ 0.05],留置胃管组住院时间最短,术后排气、排便最早.术后1周患者血红蛋白、血浆清蛋白在留置胃管组、肠内营养组与对照组间差异有统计学意义（均P＜0.05）,三组术后与术前相比均有不同程度下降,但术后留置胃管组与单纯营养组间差异无统计学意义（P＞0.05）.结论 结肠癌患者术后留置胃管并同时给予肠内营养是合理的选择.     

Enhanced recovery after surgery (ERAS) versus standard recovery for elective gastric cancer surgery: A meta-analysis of randomized controlled trials

Enhanced recovery after surgery (ERAS) protocols have been effective in improving postoperative recovery after major abdominal surgeries including colorectal cancer surgery, however its impact after gastric cancer surgery is unclear. A systematic review and meta-analysis was conducted to evaluate the effect of ERAS after gastric cancer surgery. Medline, EMBASE, CENTRAL, and PubMed was searched from database inception to December 2018. Randomized controlled trials (RCTs) comparing ERAS versus standard care in gastric cancer surgery were included. Outcomes included the postoperative length of stay (LOS), hospital costs, time to first flatus, defecation, oral intake, and ambulation after surgery, and complications. Pooled estimates were calculated using random-effects meta-analysis. The GRADE approach assessed overall quality of evidence. 18 RCTs involving 1782 patients were included. ERAS significantly reduced the LOS (Mean Difference (MD) −1.78 days, 95%CI -2.17 to −1.40, P < 0.0001), reduced hospital costs (MD -650 U S. dollars, 95%CI -840 to −460, P < 0.0001), and reduced time to first flatus, defecation, ambulation, and oral intake. ERAS had significantly lower rates of pulmonary infections (Risk Ratio (RR) 0.48, 95%CI 0.28 to 0.82, P = 0.007), but not surgical site infections, anastomotic leaks, and postoperative complications. However, ERAS significantly increased readmissions (RR 2.43, 95%CI 1.09 to 5.43, P = 0.03). The quality of evidence was low to moderate for all outcomes. Implementation of an ERAS protocol may reduce LOS, costs, and time to return of function after gastric cancer surgery compared to conventional recovery. However, ERAS may increase the number of postoperative readmissions, albeit with no impact on the rate of postoperative complications.     

快速康复外科对根治性远端胃切除患者预后的影响

目的:评价快速康复外科对根治性远端胃切除患者预后的影响。方法:按照随机对照临床试验设计要求,收集广州军区武汉总医院自2013年7至2015年6月,共计162例根治性远端胃切除患者被随机分为快速康复组和传统治疗组,比较两组患者的手术及术后恢复相关评价指标。结果:共计157例患者完成试验,传统治疗组78例,快速康复组79例。快速康复组2例患者因撤销知情同意而出组,传统治疗组3例患者因为无法完成根治性远端胃切除而出组;快速康复组与传统治疗组相比,患者肛门通气时间、排便时间、术后住院时间缩短,总住院费用减少(P＜0.05),术后前三天疼痛缓解明显(P＜0.05);术后并发症无显著性差异（P=0.502）。结论:快速康复外科理念应用于根治性远端胃癌患者安全有效,可明显加快术后康复进程。     

快速康复外科理念在腹腔镜结直肠癌围手术期中的临床应用研究

摘要 目的：回顾性分析快速康复外科理念在腹腔镜结直肠癌围手术期中的应用价值,探讨其广泛应用于结直肠癌手术中的可行性及安全性;方法：选取2016年1月至12月在我科接受快速康复治疗的41例结直肠癌患者的病例资料作为研究组,选取同期未接受快速康复治疗53例患者的病例资料作为对照组,对两组患者围手术期各项指标、并发症发生率进行分析比较;结果：两组患者在性别、年龄、肿瘤TNM分期、手术时间、术中出血量,术后并发症的发生率、术前超敏C反应蛋白（hypersensitive c-reactive protein,hs-CRP）及血清白蛋白水平之间差异不具有统计学意义（P>0.05）。研究组术后首次排气时间、首次排便时间、术后下床时间均早于对照组;术后住院时间较短;术后第三天、第七天hs-CRP水平均出现升高,但均低于对照组,血清白蛋白水平显著高于对照组,且差异具有统计学意义(P<0.05);结论：快速康复外科理念可显著减轻手术对患者的应激反应,促进患者康复,且没有增加术后并发症的发生率,应用于腹腔镜结直肠癌围手术期是安全可行的。     

快速康复外科理念下针药联合对腹腔镜结直肠癌术后患者胃肠功能的影响

目的 探讨基于快速康复外科理念下电针联合吴茱萸热熨治疗对腹腔镜结直肠癌术后患者胃肠功能恢复的影响及其安全性.方法 选取2019年10月—2020年12月在贵州省人民医院普外科住院治疗的60例结直肠癌患者为研究对象,随机分为观察组和对照组,每组30例.对照组围术期采用快速康复外科理念治疗,观察组在对照组的基础上予以电针双...     

Effect of early enteral nutrition on postoperative nutritional status and immune function in elderly patients with esophageal cancer or cardiac cancer

Objective

To explore the effect of early enteral nutrition (EN) on postoperative nutritional status, intestinal permeability, and immune function in elderly patients with esophageal cancer or cardiac cancer.

Methods

A total of 96 patients with esophageal cancer or cardiac cancer who underwent surgical treatment in our hospital from June 2007 to December 2010 were enrolled in this study. They were divided into EN group (n=50) and parenteral nutrition (PN) group (n=46) based on the nutrition support modes. The body weight, time to first flatus/defecation, average hospital stay, complications and mortality after the surgery as well as the liver function indicators were recorded and analyzed. Peripheral blood samples were collected on the days 1, 4 and 7 after surgery. The plasma diamine oxidase (DAO) activity and D-lactate level were determined to assess the intestinal permeability. The plasma endotoxin levels were determined using dynamic turbidimetric assay to assess the protective effect of EN on intestinal mucosal barrier. The postoperative blood levels of inflammatory cytokines and immunoglobulins were determined using enzyme-linked immunosorbent assay (ELISA).

Results

After the surgery, the time to first flatus/defecation, average hospital stay, and complications were significantly less in the EN group than those in the PN group (P<0.05), whereas the EN group had significantly higher albumin levels than the PN group (P<0.05). On the 7th postoperative day, the DAO activity, D-lactate level and endotoxin contents were significantly lower in the EN group than those in the PN group (all P<0.05). In addition, the EN group had significantly higher IgA, IgG, IgM, and CD4 levels than the PN group (P<0.05) but significantly lower IL-2, IL-6, and TNF-α levels (P<0.05).

Conclusions

In elderly patients with esophageal cancer or cardiac cancer, early EN after surgery can effectively improve the nutritional status, protect intestinal mucosal barrier (by reducing plasma endoxins), and enhance the immune functionKey Words: Enteral nutrition, nutritional status, intestinal permeability, endotoxin, immune function     

术前营养风险筛查在评估前列腺癌根治术快速康复方案可行性中的作用

目的:探讨术前营养风险筛查评估前列腺癌根治术围手术期快速康复可行性的作用。方法:我们进行了一个回顾性队列研究,纳入2013年10月至2018年12月于宜兴市人民医院行前列腺癌根治术的224名患者,所有患者均由同一团队行前列腺癌根治术。我们分别采用NRS-2002评分和PG-SGA评分对所有患者进行术前营养风险筛查,2016年12月起我院采取快速康复外科（enhanced recovery after surgery,ERAS）策略,比较营养风险组和营养正常组术后住院天数、导尿管留置时间、引流管留置时间、首次排便时间、独立活动时间以及术后并发症发生情况等,以及不同营养风险患者在ERAS和常规方案中的住院天数、导尿管留置时间、术后并发症发生情况等的差异。结果:营养风险组和营养正常组患者在年龄、手术时间、术中出血量、术后Gleason评分等方面均无统计学差异,营养状况与BMI具有相关性。根据NRS-2002和PG-SGA量表,营养正常患者中,ERAS组较常规组住院天数、导尿管留置时间、引流管留置时间、首次排便时间以及独立活动时间都有明显改善,差异有统计学意义;而在营养风险患者中,ERAS组较常规组住院天数和首次排便时间都明显延长,差异有统计学意义。结论:术前进行营养评估有助于筛选营养风险患者,避免不必要的术后恢复风险,选择合适的ERAS患者,值得在泌尿外科临床工作中推广应用。     

Analysis of Laparoscopy-assisted Gastric Cancer Operations Performed by Inexperienced Junior Surgeons

To clarify whether gastric cancer patients can benefit from laparoscopy-assisted surgery completed by junior surgeons under supervision of expert surgeons, data of 232 patients with gastric cancer underwent operation performed by inexperienced junior surgeons were reviewed. Of the 232 patients, 137 underwent laparoscopyassisted resection and in 118 cases this approach was successful. All of these 118 patients were assigned to laparoscopic group in this study, 19 patients who were switched to open resection were excluded. All laparoscopicoperations were performed under the supervision of expert laparoscopic surgeons. Some 95 patients receiving open resection were assigned to the open group. All open operations were completed independently by the same surgeons. Short-term outcomes including oncologic outcomes, operative time intra-operative blood loss, time to first flatus, time to first defecation, postoperative hospital stay and perioperative complication were compared between the two groups. The numbers of lymph nodes harvested in the laparoscopic and open groups were21.1±9.6 and 18.2±9.7 (p=0.029). There was no significant difference in the length of margins. The mean operative time was 215.9±32.2 min in laparoscopic group and 220.1±34.6min in the open group (p=0.866), and the mean blood loss in laparoscopic group was obviously less than that in open group (200.9±197.0ml vs 291.1±191.4ml; p=0.001). Time to first flatus in laparoscopic and open groups was 4.0±1.0 days and 4.3±1.2days respectively and the difference was not significant (p=0.135). Similarly no statically significant difference was noted for time to firstdefecation (4.7±1.6 vs 4.8±1.6, p=0.586). Eleven patients in the laparoscopic group and 19 in the open group suffered from peri-operative complications and the difference between the two groups was significant (9.3% vs 20.0%, p=0.026). The conversion rate for laparoscopic surgery was 13.9%. Patients with gastric cancer can benefit from laparoscopy-assisted operations completed by inexperienced junior surgeons under supervision of expert laparoscopic surgeons.     

腹腔热灌注化疗治疗不同Borrmann分型进展期胃癌的临床效果及对肿瘤标志物的影响#br#

目的探讨腹腔热灌注化疗（HIPEC）对于不同Borrmann分型进展期胃癌的疗效及对血清肿瘤标志物的影响。方法回顾性分析上海中医药大学附属曙光医院2011年1月至2016年1月收治的165例行腹腔镜下胃癌根治术患者的临床资料,将术后行常规静脉化疗的82例患者为对照组,行静脉化疗联合HIPEC的83例患者为观察组,比较两组患者的近期临床疗效,治疗前后血清肿瘤标志物[糖类抗原72 4（CA72 4）、糖类抗原19 9（CA19 9）、癌胚抗原（CEA）]水平变化情况,不良反应及并发症发生情况以及术后5年复发转移及生存情况。结果治疗后,观察组患者的疾病控制率及治疗有效率均高于对照组,差异具有统计学意义（P<005）,治疗期间两组患者病死率差异无统计学意义（P>005）。两组患者不良反应及并发症发生率差异无统计学意义（P>005）。对于Borrmann Ⅰ型、Ⅱ型患者,两组复发转移率及5年生存率差异无统计学意义（P>005）;对于Borrmann Ⅲ型、Ⅳ型患者,观察组的复发转移率低于对照组,5年生存率高于对照组,差异有统计学意义（P<005）。治疗前,两组患者CA72 4、CA19 9、CEA水平差异无统计学意义（P>005）,治疗后,两组患者CA72 4、CA19 9、CEA水平均低于治疗前,且观察组低于对照组,差异有统计学意义（P<005）。结论对进展期胃癌患者行胃癌根治术联合HIPEC治疗,可提高Borrmann Ⅲ、Ⅳ型患者的5年生存率,降低5年内复发率,降低血清肿瘤标志物水平,且并发症及不良反应的发生率未增加,安全性较高。     

术后早期饮水对妇科恶性肿瘤全身麻醉腹腔镜手术患者术后胃肠功能恢复的影响

目的 探讨术后早期饮水对妇科恶性肿瘤全身麻醉腹腔镜手术患者术后胃肠功能恢复的影响.方法 随机数字表、双盲原则将118例妇科恶性肿瘤腹腔镜手术患者分为对照组和观察组,各59例,对照组患者术后给予常规禁饮干预,观察组患者术后给予早期饮水干预.比较两组患者术后胃肠功能恢复时间、生命体征、口腔舒适度、并发症发生情况及患者满意度...     

快速康复在不同方式胃癌根治手术中的应用

目的:评价快速康复（fast track,FT）模式在不同方式胃癌根治手术患者术后康复中的有效性及安全性。方法:收集我科2016年1月至2017年6月期间行开放(OS)及腹腔镜(LS)胃癌根治手术患者各40例，随机分为FT处理组（OS+FT组、LS+FT组）和常规处理（NT）对照组（OS+NT组、LS+NT组），比较不同处理模式对术后疼痛评分、恢复情况和术后并发症发生率的影响。结果:OS+FT组、LS+FT组术后1、2、3、4和5 d疼痛评分均低于NT对照组，各观察时点差异均有统计学意义（P＜0.005）；OS+FT组、LS+FT组术后首次排气时间、首次离床时间以及住院时间均短于NT对照组（P＜0.05）；术后OS+FT组、LS+FT组总体并发症发生率均为10%，与NT对照组（OS+NT组20%，LS+NT组15%）相比，差异无统计学意义（P＞0.05）。结论:FT模式有利于减少患者痛苦，加速术后恢复，未增加术后并发症风险，在不同方式胃切除手术患者围术期处理过程中安全、有效。     

加速康复外科理念在胃癌根治术中应用效果的Meta分析

目的:评价加速康复外科理念在胃癌根治术围手术期应用的有效性与安全性。方法:检索Pubmed、Embase、Cochrane Library、中国生物医学文献数据库（SinoMed）、中国知网（CNKI）、维普、万方等数据库中关于加速康复外科在胃癌根治术中应用的随机对照试验,检索时间为1995年1月至 2018年2月。两位研究人员独立进行质量评价与资料提取,采用RevMan5.2软件进行Meta分析。结果:纳入14篇文献,共1 340例患者,包括加速康复外科组669例,对照组671例。相较于对照组,加速康复外科术后首次排气时间［SMD=-1.38,95%CI（-1.89,-0.87）,P＜0.000 01］、首次排便时间［SMD=-1.62,95%CI（-2.62,-0.63）,P=0.001］缩短;住院时间［WMD=-2.26,95%CI（-2.67,-1.84）,P＜0.000 01］、住院费用［SMD=-0.65,95%CI（-1.04,-0.26）,P=0.001］减少;总并发症发生率降低［OR=0.65,95%CI（0.46,0.93）,P=0.02］。但再入院［RR=1.01,95%CI（0.24～4.36）,P=0.99］并没有明显差异。结论:加速康复外科在胃癌根治术围手术期中应用是安全有效的,有利于促进患者的康复,具有临床应用价值,但需要更多高质量的循证证据支持。     

Laparoscopy-assisted transanal total mesorectal excision for lower rectal cancer: A feasible and innovative technique

BACKGROUNDTransanal total mesorectal excision (taTME) is a new technique with many potential technical advantages. Laparoscopy-assisted taTME is a combination of transabdominal taTME and transluminal endoscopic surgery taTME. Laparoscopy-assisted taTME is a combination of techniques such as minimally invasive surgery, intersphincter-assisted resection, natural orifice extraction, ta minimally invasive surgery, and ultralow-level preservation of the anus.AIMTo verify the feasibility and safety of an innovative technique of taTME for treatment of cancer located in the lower rectum.METHODSFrom January 2016 to March 2018, we attempted to perform laparoscopy-assisted taTME surgery in 24 patients with lower rectal cancer.RESULTSThe new technique of laparoscopy-assisted taTME was successfully performed in all 24 patients. Mean operating time was 310.0 min and mean intraoperative blood loss was 69.1 mL. The mean time to passing of first flatus was 3.1 d, and mean postoperative hospital stay was 9.2 d. Two patients were given postoperative analgesics due to anal pain. Twenty-three patients were able to walk in first 2 d, and five patients had postoperative complications.CONCLUSIONLaparoscopy-assisted taTME is suitable for selected patients with lower rectal cancer, and this technique is worthy of further recommendation.     

术后早期肠内营养在食管癌围手术期快速康复治疗中的应用

目的:探讨快速康复外科理念应用于临床治疗的方法。方法:应用快速康复外科(fast track surgery,FTS)治疗理念,分析我院56例食管癌患者的临床资料。采用前瞻性随机分组为实验组(FTS)组和对照组,观察两组病例术前及术后血清蛋白改变、术后肠道恢复时间、肛门排气时间、住院时间及花费情况。结果:实验组肠鸣音恢复时间、肛门排气时间、住院时间及住院花费均少于对照组(P<0.05),术后血清蛋白恢复实验组亦高于对照组。结论:快速康复外科理念应用于食管癌围手术期治疗,在不增加术后并发症的前提下,可明显促进患者康复及缩短住院时间。     

多学科协作模式的延续性管理对乳腺癌患者术后恢复及不良情绪的影响

目的探讨多学科协作模式的延续性管理对乳腺癌患者术后恢复及不良情绪的影响。方法依据术后干预方式的不同将80例乳腺癌根治术后患者分为常规组(n=35)和多学科协作管理组(n=45),常规组实施常规术后干预,多学科协作管理组在此基础上实施多学科协作模式的延续性管理。比较两组患者的疼痛程度、不良情绪、营养指标、肢体功能恢复情况及自护能力。结果干预后,多学科协作管理组患者的视觉模拟评分量表(VAS)、焦虑自评量表(SAS)和抑郁自评量表(SDS)评分均明显低于常规组,血清白蛋白(ALB)、血清前白蛋白(PAB)水平均明显高于常规组(P﹤0.01)。干预后,多学科协作管理组患者肩关节内收、肩关节外展、肩关节伸屈和肩关节后伸的活动度均明显大于常规组(P﹤0.01)。干预后,多学科协作管理组患者的自护技能、自护责任感、自我概念和健康知识水平评分均明显高于常规组(P﹤0.01)。结论多学科协作模式的延续管理能够缓解乳腺癌术后患者的疼痛及焦虑、抑郁情绪,改善营养状态,促进肢体功能恢复,提高其自护能力。