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乳腺癌淋巴水肿的发病率及危险因素。

Incidence and risk factors of breast cancer lymphoedema.

作者信息

Park Jin Hee, Lee Won Hee, Chung Hae Soo

机构信息

College of Nursing, Ajou University, Seoul, Korea.

出版信息

J Clin Nurs. 2008 Jun;17(11):1450-9. doi: 10.1111/j.1365-2702.2007.02187.x.

Abstract

AIM

The purpose of this study was to examine the incidence of lymphoedema and to identify risk factors of lymphoedema in patients with breast cancer undergoing mastectomy in Korea.

BACKGROUND

Lymphoedema is a serious problem for many breast cancer survivors. Although the potential impact of lymphoedema is extensive, it is largely unrecognised.

METHODS

Women with breast cancer (n = 450) receiving mastectomy were recruited from outpatient breast cancer clinics of two university hospitals in Seoul, Korea from October 2004 to May 2005. Lymphoedema was defined by circumferential measurement. This study examined the risk factors associated with lymphoedema through the literature review. A descriptive design was used for this study and data were collected using structured questionnaire. Data were analysed by chi-square test and multiple logistic regression.

RESULTS

Among the 450 cases of breast cancer, 24.9% had developed lymphoedema. There were significantly increased risks of lymphoedema if women were with higher staging, had modified radical mastectomy, had axillary lymph node dissection, received axillary radiotherapy and were with body mass index greater than 25 kg/m(2). A significantly decreased risk of lymphoedema was found in women who exercised regularly, received pretreatment education of lymphoedema and had performed preventive self-care activities.

CONCLUSIONS

Lymphoedema is recognised as an unpleasant and uncomfortable consequence of breast cancer-related treatment. Patients should be advised of the risk of lymphoedema and educated to detect its symptoms. Relevance to clinical practice. It is of importance to recognise breast cancer patients at risk for lymphoedema. Nurses should inform patients with breast cancer about their risk for lymphoedema and guidelines to reduce the risk and to emphasise self-care activities for prevention.

摘要

目的

本研究旨在调查韩国接受乳房切除术的乳腺癌患者淋巴水肿的发生率,并确定淋巴水肿的危险因素。

背景

淋巴水肿是许多乳腺癌幸存者面临的严重问题。尽管淋巴水肿的潜在影响广泛,但在很大程度上未得到认识。

方法

2004年10月至2005年5月,从韩国首尔两家大学医院的门诊乳腺癌诊所招募了450例接受乳房切除术的乳腺癌女性患者。通过周径测量定义淋巴水肿。本研究通过文献回顾研究了与淋巴水肿相关的危险因素。本研究采用描述性设计,使用结构化问卷收集数据。数据采用卡方检验和多元逻辑回归分析。

结果

在450例乳腺癌病例中,24.9%发生了淋巴水肿。如果女性分期较高、接受改良根治性乳房切除术、腋窝淋巴结清扫、接受腋窝放疗且体重指数大于25kg/m²,则淋巴水肿风险显著增加。在经常锻炼、接受淋巴水肿预处理教育并进行预防性自我护理活动的女性中,发现淋巴水肿风险显著降低。

结论

淋巴水肿被认为是乳腺癌相关治疗令人不快且不适的后果。应告知患者淋巴水肿的风险,并对其进行教育以发现其症状。与临床实践的相关性。识别有淋巴水肿风险的乳腺癌患者非常重要。护士应告知乳腺癌患者其淋巴水肿风险以及降低风险的指南,并强调预防的自我护理活动。

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