Liao Xiuting, Cao Guo, Yang Ling, Wang Chunli, Tian Changying
Altern Ther Health Med. 2023 Sep;29(6):242-247.
Gynecological malignancies can pose a serious threat to women's physical and mental health, and lymphedema is one of the common complications after surgery for malignant tumors. Comprehensive nursing might be able to reduce the lymphedema that occurs after surgery and help accelerate patients' postoperative rehabilitation process.
The study intended to explore the effects of a comprehensive nursing intervention for patients with lower-limb lymphedema after surgery for malignant gynecological tumors.
The research team performed a retrospective controlled study.
The study took place at Sichuan Cancer Hospital in Chengdu, China.
Participants were 90 patients who received surgical treatment at the hospital for malignant gynecological tumors between April 2020 and July 2021.
The research team divided participants into two groups: (1) 45 in the intervention group who received a comprehensive nursing intervention based on a meta-heuristic learning model, and (2) 45 in the control group, who received routine nursing. The nursing intervention occurred for both groups for one year, from admission for surgery, baseline, to the end of treatment, postintervention.
The research team: (1) assessed the efficacy postintervention of the nursing intervention for the two groups, (2) measured the circumference of participants' lower-limb edema at baseline and postintervention, (3) determined the incidence of lymphedema between baseline and postintervention in the two groups, (4) measured the nursing satisfaction scores of the two groups postintervention, and (5) evaluated participants' quality of life using the Abbreviated World Health Organization Quality-of-Life (WHOQOL-BREF) scale at baseline and postintervention.
Postintervention: (1) the efficacy of the nursing intervention for the intervention group was 95.56%, which was a significantly higher rate than that of the control group, at 82.22% (P = .044); (2) the intervention group's decrease in the mean circumference at 10 cm below the knee was significantly greater, from 40.43 ± 1.75 cm to 34.93 ± 1.94 cm, than that of the control group, from 39.93 ± 2.01 cm to 35.89 ± 2.27 cm (P = .034), and that group's decrease in the mean circumference at 10 cm above the knee was also significantly greater, from 49.50 ± 3.06 cm to 44.12 ± 2.14 cm, than that of the control group, from 49.13 ± 3.11 cm to 46.10 ± 1.94 cm (P < .001); (3) of the 45 participants in the intervention group, only one had lymphedema (2.22%), which was a significantly lower rate than that of the control group, at six participants out of 45 (13.33%), with P = .049; (4) the intervention group's mean score for nursing satisfaction was 86.59 ± 3.96, which was significantly higher than that of the control group, at 82.22 ± 5.61 (t = 4.269, P < .001); and (5) the intervention group's mean score on the WHOQOL-BREF scale was 25.52 ± 2.94, which was significantly higher than that of the control group, at 22.28 ± 3.00 (t = 5.174, P < .001).
A comprehensive nursing intervention after surgery for patients with gynecological malignancies can reduce the incidence of lymphedema, be more effective, and enhance patients' satisfaction with nursing care and their quality of life.
妇科恶性肿瘤会对女性身心健康构成严重威胁，淋巴水肿是恶性肿瘤手术后常见的并发症之一。综合护理或许能够减少术后发生的淋巴水肿，并有助于加速患者术后康复进程。
本研究旨在探讨综合护理干预对妇科恶性肿瘤术后下肢淋巴水肿患者的影响。
研究团队进行了一项回顾性对照研究。
本研究在中国成都的四川省肿瘤医院开展。
参与者为2020年4月至2021年7月期间在该医院接受妇科恶性肿瘤手术治疗的90例患者。
研究团队将参与者分为两组：（1）干预组45例，接受基于元启发式学习模型的综合护理干预；（2）对照组45例，接受常规护理。两组的护理干预均从手术入院、基线期开始，持续至治疗结束、干预后期，为期一年。
研究团队：（1）评估两组护理干预的干预后疗效；（2）测量参与者基线期和干预后的下肢水肿周长；（3）确定两组基线期至干预后期淋巴水肿的发生率；（4）测量两组干预后的护理满意度得分；（5）在基线期和干预后使用世界卫生组织生存质量测定简表（WHOQOL-BREF）评估参与者的生活质量。
干预后：（1）干预组护理干预的有效率为95.56%，显著高于对照组的82.22%（P = 0.044）；（2）干预组膝下10 cm处平均周长的减少幅度显著大于对照组，从40.43±1.75 cm降至34.93±1.94 cm，而对照组从39.93±2.01 cm降至35.89±2.27 cm（P = 0.034），且干预组膝上10 cm处平均周长的减少幅度也显著大于对照组，从49.50±3.06 cm降至44.12±2.14 cm，而对照组从49.13±3.11 cm降至46.10±1.94 cm（P < 0.001）；（3）干预组45例参与者中，仅1例发生淋巴水肿（2.22%），显著低于对照组的45例中有6例（13.33%），P = 0.049；（4）干预组护理满意度的平均得分为86.59±3.96，显著高于对照组的82.22±5.61（t = 4.269，P < 0.001）；（5）干预组在WHOQOL-BREF量表上的平均得分为25.52±2.94，显著高于对照组的22.28±3.00（t = 5.174，P < 0.001）。
妇科恶性肿瘤患者术后进行综合护理干预可降低淋巴水肿的发生率，效果更佳，并提高患者对护理的满意度及其生活质量。
