护理学杂志2023年5月第38卷第9期91·循证护理·宫颈癌根治术后患者下肢淋巴水肿自我护理的最佳证据总结王焕焕'，吕永利2，王培红'，耿力摘要：目的检索、评价和汇总宫颈痛根治术后患者下肢淋巴水肿自我护理的最佳证据，为临床护理工作提供参考。方法按照“6S”金字塔模型系统检索国内外数据库关于宫颜癌根治术后惑者下肢淋巴水肿自我护理的证据，包括临床决策，描南、证据汇总、推荐实践、系统评价及专家共识。检索时限从建库至2022年1月。结果共纳入11篇文献，包括临床决策1篇、指南3篇、系统评价3篇、证据总结1篇、专家共识3篇，证据主要涉及危险固素、自我护理措施、健康教育与随访3个方面，包含10个亚主题共23条证据，结论临床医护人员应将临床县体情景与循证医学证据相结合，选择有针对性的最佳证据，为下肢淋巴水肿惑者提供科学的护理指导，提升惠者自我护理能力，关键词：宫颈瘤；下肢淋巴水肿：自我护理：危险因素：健康教有：最佳证据总结：循证护理中图分类号：R473.71D0I:10.3870/1.issn1001-4152.2023.09.091Summary of the evidence on self-care of lower-limb lymphedema after surgery for cervical cancer Wang Huanhuan,Lv Yongli,Wang Peihong,Geng Li.Department of Gynecology and Obstetrics,Union Hospital,Tongji Medical College,Huazhong Uni-versity of Science and Technology,Wuhan 430022,ChinaAbstract:Objective To retrieve,evaluate and summarize the best evidence on self-care of lower-limb lymphedema after surgery forcervical cancer,so as to provide reference for clinical nursing practice.Methods Following the 6S evidence pyramid model,electro-nic databases or websites were searched for literature regarding self-care of lower-limb lymphedema after surgical treatment of ce-rvical cancer from database inception to January 2022.The literat ure included computerised decision support systems report,guide-line,evidence summary,clinical practice recommendations statement,systematic review,and expert consensus statement.ResultsA total of 11 publications were eligible,including 1 decision support system report.3 guidelines,3 systematic reviews,1 evidencesummary and 3 expert consensus statement reports.Twenty-three pieces of evidence were identified,embracing three aspects (riskfactors,self-care measures,health education and follow-up)and ten subthemes.Conclusion Clinical medical staff should considerspecific clinical situation to select the best evidence,and provide scientific nursing guidance for patients with lower-limb lymphe-dema,thus to improve their self-care ability.Key words:cervical cancer:lower-limb lymphedema:self-care:risk factor:health education:evidence summary:evi-dence-based nursing下肢淋巴水肿(Lower Extremity Lymphedema,供科学的护理指导，以提升患者自我护理能力。LEL)是宫颈癌术后常见并发症之一，是由于手术或1资料与方法放疗等造成淋巴结或淋巴管受损，导致淋巴液回流障1.1问题确定为获取宫颈癌根治术后患者下肢淋碍而滞留在组织中，属于继发性水肿四。据文献报巴水肿自我护理的最佳证据，按照PIPOST模式提出道，宫颈癌治疗后下肢淋巴水肿发生率为2.3%~循证护理实践问题。P(Population):证据应用群体，47.6%2-)。虽然下肢淋巴水肿不属于致命性疾病，即宫颈癌根治术后患者；I(Intervention):干预措施，一旦发生却很难根治，严重影响患者生活质量和社会为淋巴水肿评估、下肢淋巴水肿自我护理方法：P功能)。作为慢性进展性疾病，早期发现并及时干预(Professional)):实施者，包括临床管理者、医护工作具有重要意义。国内尚缺乏宫颈癌术后下肢淋巴水者、患者及家属；O(Outcome):证据应用后结局，即下肿预防与管理相关的护理指南，对宫颈癌术后下肢淋肢淋巴水肿发生率、护士知晓率及患者知晓率：S巴水肿患者的自我护理还未引起足够重视，宫颈癌根(Setting):证据应用地点，妇科肿瘤病区及发生下肢治术后下肢淋巴水肿也容易被医护人员及患者忽视。淋巴水肿患者出院后的居家场所；T(Type of Evi-本研究总结宫颈癌根治术后下肢淋巴水肿自我护理dence):证据类型，即临床决策、指南、证据汇总、推荐的最佳证据，旨在为护理人员对下肢淋巴水肿患者提实践、系统评价及专家共识。1.2检索策略按照“6S”循证金字塔模型进行宫颈作者单位：华中科技大学同济医学院附属协和医院1.妇产科2.护理部癌根治术后下肢淋巴水肿自我护理的最佳证据检索。(湖北武汉，430022)王焕焕：女，硕士，主管护师英文关键词：gynecologic oncology,gynecology,gy-通信作者：吕永利，371220983@g9.comnecologic carcinoma,gynecological cancer,cervical科研项目：湖北省自然科学基金资助项目(2021CFB589):湖北省
