改良皮瓣引流护理方案在乳腺癌术后患者中的应用效果

目的 探讨改良皮瓣引流护理方案在乳腺癌术后患者皮下积液中的应用效果。 方法选取我院2016年1月-2018年1月收治的术后发生皮下积液的乳腺癌患者94例,将其随机分成对照组与观察组,每组47例。对照组术后接受常规护理,观察组患者接受改良皮瓣引流护理方案,即采用弹力包扎带加压,应用组合引流方案进行皮瓣引流,并使用制动袖套约束患者动作范围。比较2组患者腋窝及胸部引流量、并发症发生情况、生活质量、炎症因子、疼痛程度。 结果 2组患者腋窝及胸部引流量在时间、组间及交互效应方面比较,差异均具有统计学意义。观察组并发症发生率低于对照组(χ²=11.692,P<0.001),患者生活质量评分显著高于对照组。观察组炎症因子TNF-α和IL-6水平均明显低于对照组(t=11.539,P<0.001; t=57.808,P<0.001);观察组疼痛评分显著低于对照组(t=16.142,P<0.001)。 结论 改良皮瓣引流护理方案能减少乳腺癌患者术后皮下积液、皮瓣坏死、上肢肿胀,提高患者生活质量,减轻疼痛,值得推荐使用。

Application of skin fap drainage nursing for postoperative subcutaneous effusion of patients with breast cancer

Objective To investigate the effect of modified skin flap drainage nursing on postoperative subcutaneous effusion of patients with breast cancer. Methods Ninety-four breast cancer patients with postoperative subcutaneous effusion in our hospital between January 2016 and January 2018 were selected and randomly divided into a control group and an observation group, each of 47. The control group received routine nursing, while the observation group received modified skin flap drainage nursing. The drainage volume, incidence of complications, quality of life, inflammatory factors and pain degree were compared between the two groups. Result There were significant differences of the axillary and thoracic drainage volume in time, intergroup or interaction effect between 2 groups. The incidence of complication of the observation group was significantly lower than that of the control group (χ²=11.692,P<0.001). Moreover, the serum TNF-α and IL-6 levels, and VAS score of the former group were significantly lower than the latter(t=11.539,P<0.001; t=57.808,P<0.001; t=16.142,P<0.001), while the life quality score was significantly higher than the latter. Conclusion The application of modified flap drainage nursing program can reduce incidence of the postoperative subcutaneous effusion, skin flap necrosis, upper limb swelling, improve quality of life, as well as reduce the pain degree of breast cancer patients.