姑息治疗中水肿/淋巴水肿的评估、治疗目标及干预措施

Assessment, treatment goals and interventions for oedema/lymphoedema in palliative care.

作者信息

Cobbe Sinead, Real Shirley, Slattery Sinead

机构信息

Senior Physiotherapist, at Milford Care Centre, Limerick, Ireland.

Physiotherapy Manager, at Milford Care Centre, Limerick, Ireland.

出版信息

Int J Palliat Nurs. 2017 Mar 16;23(3):111-119. doi: 10.12968/ijpn.2017.23.3.111.

DOI:10.12968/ijpn.2017.23.3.111

PMID:28345474

Abstract

BACKGROUND

Little is known about the treatment of oedema in palliative care patients.

AIM

To outline the assessment, goals, and interventions for patients with oedema.

METHOD

A 6-month chart review of a specialist physiotherapy-led oedema service was carried out.

RESULTS

Of the sample group (n=63), 28.6% of patients had lymphoedema, 15.9% had non-lymphatic oedema, 46% had mixed oedema and 9.8% had lymphorrhoea; 58 patients (92%) had cancer. The most common interventions were providing education (100%, n=63), using compression garments (58%, n=37), bandaging (51%, n=32), exercise (38%, n=24), lymphatic massage and kinesio-taping (35%, n=22 each). Treatment regime differed depending on the type of oedema present. Treatment goals were pragmatic: the most common were to maintain skin quality (54%, n=34), reduce limb volume (52%, n=32), and improve quality of life (48%, n=30).

CONCLUSION

Palliative care oedema can be treated using manual methods, including compression and massage. Goals differ from other oedema populations. Research is hampered by lack of suitable measures to record skin changes and quality of life.

摘要

背景

对于姑息治疗患者水肿的治疗了解甚少。

目的

概述水肿患者的评估、目标及干预措施。

方法

对一项由专科物理治疗师主导的水肿服务进行了为期6个月的病历审查。

结果

在样本组（n = 63）中，28.6%的患者患有淋巴水肿，15.9%患有非淋巴性水肿，46%患有混合性水肿，9.8%患有淋巴漏；58名患者（92%）患有癌症。最常见的干预措施是提供教育（100%，n = 63）、使用压力衣（58%，n = 37）、绷带包扎（51%，n = 32）、运动（38%，n = 24）、淋巴按摩和肌内效贴布（各35%，n = 22）。治疗方案因现有水肿类型而异。治疗目标注重实际：最常见的是保持皮肤质量（54%，n = 34）、减少肢体体积（52%，n = 32）和改善生活质量（48%，n = 30）。