CAJ | 학술논문

目的：应用循证护理探讨乳腺癌术后引流量、皮下积液及功能锻炼的关系。方法选取2012年1月—2013年10月收治的60例乳腺癌术后患者为研究对象。采用随机数字表法分为研究组32例和对照组28例，对照组应用常规护理措施，研究组采用循证护理，搜索国内外相关护理文献，评价有关乳腺癌术后引流量、皮下积液及功能锻炼的关系的文献证据，应用证据制定护理计划。观察两组患者术后第14天肢体肿胀发生率、皮下积液发生率和术后第4周患肢功能恢复情况。结果研究组患者皮下积液发生率为15．6％，低于对照组的21．4％，差异有统计学意义（χ2＝10．23，P＜0．05）；研究组患肢肿胀发生率为31．3％，低于对照组的32．1％，但差异无统计学意义（χ2＝3．52，P＞0．05）。研究组手术前后患肢功能差距小于对照组（t值分别为7．68，8．65，7．25；P＜0．05），且研究组临床疗效优16例，良14例，一般2例，与对照组比较差异有统计学意义（u＝2．63，P＜0．05）。结论乳腺癌患者术后第3日引流量超过500 ml或术后第5日引流量超过30 ml，暂停肩关节锻炼，待日引流量小于10 ml开始肩关节活动，可以降低术后第14天的肢体肿胀发生率和皮下积液发生率，有利于术后4周内的患肢功能恢复。
목적：응용순증호리탐토유선암술후인류량、피하적액급공능단련적관계。방법선취2012년1월—2013년10월수치적60례유선암술후환자위연구대상。채용수궤수자표법분위연구조32례화대조조28례，대조조응용상규호리조시，연구조채용순증호리，수색국내외상관호리문헌，평개유관유선암술후인류량、피하적액급공능단련적관계적문헌증거，응용증거제정호리계화。관찰량조환자술후제14천지체종창발생솔、피하적액발생솔화술후제4주환지공능회복정황。결과연구조환자피하적액발생솔위15．6％，저우대조조적21．4％，차이유통계학의의（χ2＝10．23，P＜0．05）；연구조환지종창발생솔위31．3％，저우대조조적32．1％，단차이무통계학의의（χ2＝3．52，P＞0．05）。연구조수술전후환지공능차거소우대조조（t치분별위7．68，8．65，7．25；P＜0．05），차연구조림상료효우16례，량14례，일반2례，여대조조비교차이유통계학의의（u＝2．63，P＜0．05）。결론유선암환자술후제3일인류량초과500 ml혹술후제5일인류량초과30 ml，잠정견관절단련，대일인류량소우10 ml개시견관절활동，가이강저술후제14천적지체종창발생솔화피하적액발생솔，유리우술후4주내적환지공능회복。
Objective To apply the evidence-based nursing on the relationship between the functional exercise and drainage, subcutaneous effusion after breast cancer operation.Methods Sixty breast cancer patients which admitted from January 2012 to October 2013 were divided into control group ( twenty eight cases) and experimental group ( thirty two cases) .The control group just accepted routine care while the experimental group received evidence-based nursing care.The evidence related nursing plan making were collected from national and international literature and mainly focused on the relationship between functional excises and the value of drainage, subcutaneous effusion after breast cancer operation.After fortnight operation, the rate of swelling and the rate of subcutaneous effusion were observed, and the recovery of function had been assessed after the day of four weeks operation.Results The subcutaneous effusion of the experimental group (15.6%) were lower than that of control group (21.4%), with a significant difference between two groups (χ2 =10.23;P<0.05).The rate of limb swelling of the experimental group was 31.3%,which was lower than that of the control group (32.1%),the difference was not statically significant (χ2 =3.52,P>0.05).The recovery of affected limb function in the experimental group had better result than the control group (t=7.68,8.65,7.25, respectively;P<0.05).In the experimental group, the clinical curative effects had sixteen cases showed excellent, four cases ( fine) and two cases ( general) that had statistical significance comparing with control group (u=2.63,P<0.05).Conclusions When the breast cancer patients had the value of drainage over than 500 ml at the third of operation day or more than 30 ml at the fifth day, it is better to stop function exercise until the value of drainage lower than 10 ml daily.The above procedure can release swelling and subcutaneous effusion at fourteenth operation day’ s assessment, and benefit functional recovery after four weeks operation.