中华护理杂志2023年2月第58卷第3期证据综合研究乳腺癌相关淋巴水肿非药物干预的证据总结李佳倩强万敏魏婷婷朱明玉李苗苗沈傲梅武佩佩王盈【摘要】目的运用循证的方法整合乳腺癌相关淋巴水肿非药物干预的最佳证据，为临床医护人员对淋巴水肿开展规范化评估和管理提供循证依据。方法系统检索各指南网站及中英文数据库有关乳腺癌患者淋巴水肿预防和管理的相关指南、专家共识、系统评价等证据，检索时限为2016年1月一2022年1月。结果共纳入25篇文献，包括6篇指南、4篇专家共识、15篇系统评价，围绕预防性千预、治疗性千预2个方面总结33条最佳证据。结论该研究总结的证据可用于防治乳腺癌淋巴水肿，医护人员需结合文化背景、临床情境、患者意见，为淋巴水肿患者提供针对性的健康指手。【关键词】乳腺癌；淋巴水肿；非药物干预；证据总结；循证护理学Evidence summary for non-pharmacological interventions of breast cancer-related lymphedema/LI Jiagian,QIANG Wanmin,WEI Tingting,ZHU Mingyu,LI Miaomiao,SHEN Aomei,WU Peipei,WANG Ying[Abstract]Objective To integrate the best evidence of non-pharmacological interventions for breast cancer-related lymphedema with evidence-based methods,and to provide evidence-based bases for standardized evaluationand management of lymphedema for clinical medical staff.Methods The best evidence about the prevention andmanagement of lymphedema in breast cancer patients were searched systematically,such as relevant guidelines,expert consensuses,systematic reviews and so on.The retrieval period was from January 2016 to January 2022.Results A total of 25 pieces of the literature were included,including 6 guidelines,4 expert consensuses and 15systematic evaluations,and 33 pieces of best evidences were integrated from 2 aspects,namely the preventiveintervention and therapeutic intervention.Conclusion The summarized evidence can be used for the preventionand treatment of breast cancer lymphedema,and medical staff should provide specific health guidance for patientswith lymphedema based on cultural background,clinical situation,and patients'opinions.[Key words]Breast Cancer:Lymphedema:Non-pharmacological Intervention:Evidence Summary:Evide-nce-based Nursing乳腺癌是全球女性发病率最高的恶性肿瘤[山，活质量，一旦发生很难治愈)。目前，乳腺癌相关淋随着术后生存期的延长，其生活质量愈发受到重视。巴水肿非药物干预领域研究]较多，但其质量参差乳腺癌相关淋巴水肿(reast cancer-related lymphe-不齐，且通常限于淋巴水肿的预防策略，尚未形成系dema,BCRL)是乳腺癌术后最常见的慢性并发症，其统化的防治方案。因此本研究基于循证方法对乳腺发生率约为20%闪。由于手术、放化疗等治疗破坏淋癌相关淋巴水肿非药物干预的证据进行评价和总巴组织，导致淋巴系统通路受阻，大量富含蛋白质的结，形成最佳证据，为临床护理实践提供循证依据。淋巴液滞留在组织间隙而形成水肿，易引起患肢肿胀、疼痛、麻木、功能障碍等症状，严重影响患者的生1资料与方法1.1明确问题D0I:10.3761听.issn.0254-1769.2023.03.013基金项目：天津市医学重点学科（专科）建设项目(TJYXZDXK011A):天采用PICOs原则来明确循证问题。研究对象津市深化医药卫生体制改革研究项目(2022YG12)(population,P)为乳腺癌患者；干预措施(interven-作者单位：300060天津市天津医科大学肿曾医院/但家恶性肿箱tion,I)为针对淋巴水肿的非药物干预：对照(con临床医学研究中心天津市恶性肿篇临床医学研究中心/乳腺癌防trol,C)为常规护理或空白对照：结果(outcome,0)为治教育部重点实验室/乳腺癌淋巴水肿门诊（李佳情，朱明玉，武佩淋巴水肿发生率、水肿程度等结局指标：研究类型佩)，乳腺病房（魏婷婷，李苗苗），护理部（强万敏，沈做梅，王盈）通信作者：王盈，E-mail:52133433@g4.c0m(study type,S)为指南、专家共识、系统评价等。本研李佳情：女，硕士，护师，E-mail:96537877@q4c0m究已在复旦大学的网站(http:ebn.nursing.fudan.edu.20220418收稿cm/home)注册(ES20220325)。Chin J Nurs,February 2023,Vol.58,No.3349(C)1994-2023 China Academic Journal Electronic Publishing House.All rights reserved.http://www.cnki.net
