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护理学报 ›› 2021, Vol. 28 ›› Issue (4): 26-30.doi: 10.16460/j.issn1008-9969.2021.04.026

• 循证护理 • 上一篇    下一篇

延迟自体乳房重建术对上肢淋巴水肿治疗效果的系统评价

从维莲1,2, 周春兰2,3, 胡明钰2, 刘丽萍2   

  1. 1.中国科学院大学附属肿瘤医院（浙江省肿瘤医院）,浙江 杭州 310022;
    2.南方医科大学南方医院,广东 广州 510515;
    3.南方医院JBI循证护理合作中心,广东 广州 510515
  • 收稿日期:2020-07-20 出版日期:2021-02-25 发布日期:2021-03-12
  • 通讯作者: 周春兰（1962-）,女,湖南益阳人,硕士,主任护师,博士研究生导师,护理部主任。E-mail:lanchun200488@126.com
  • 作者简介:从维莲（1995-）,女,安徽六安人,硕士学历,护师。
  • 基金资助:
    2019年度南方医院护理创优-循证实践专项项目（2019EBNc002）

Effect of Delayed Autologous Breast Reconstruction on Patients with Upper Extremity Lymphedema: A systematic Review

CONG Wei-lian1,2, ZHOU Chun-lan2,3, HU Ming-yu2, LIU Li-ping2   

  1. 1.Cancer Hospital of University of Chinese Academy of Sciences Zhejiang Cancer Hospital, Hangzhou 310022, China;
    2.Nanfang Hospital, Southern Medical University, Guangzhou 510515, China;
    3.PR China Nanfang Nursing Centre for Evidence-based Practice: A JBI Centre of Excellence, Guangzhou 510515, China
  • Received:2020-07-20 Online:2021-02-25 Published:2021-03-12

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摘要： 目的 系统评价延迟自体乳房重建术治疗上肢淋巴水肿的效果。方法 检索Cochrane Library、PubMed、Embase、Scopus、Web of Science数据库,搜集关于延迟自体乳房重建术对上肢淋巴水肿治疗效果的研究,检索时间为建库至2020年6月。由2名研究员独立筛选符合标准的文献并进行数据提取,采用澳大利亚JBI循证卫生保健中心的文献质量评价工具对纳入文献质量进行评价,采用RevMan 5.3软件进行Meta分析。结果 纳入11篇文献,其中6篇纳入定量合成分析,Meta分析结果显示,64.8%（95%CI,0.32~0.88）的患者无论是否接受淋巴结移植,进行乳房重建术后淋巴水肿均有所改善。亚组分析结果显示,84.4%（95%CI,0.72~0.92）的患者在接受乳房重建术和淋巴结移植后淋巴水肿有所改善,而仅有21.9%（95%CI,0.14~0.33）的患者在只接受乳房重建术后淋巴水肿有所改善。结论 延迟自体乳房重建术可以改善乳腺癌患者术后上肢淋巴水肿,其中淋巴结移植可能是促进淋巴水肿改善的因素。

关键词: 乳房重建, 乳腺癌, 淋巴水肿, Meta分析

Abstract: Objective To systematically evaluate the effect of delayed autologous breast reconstruction in the treatment of upper limb lymphedema. Methods The databases of Cochrane Library, PubMed, Embase, Scopus and Web of Science were searched to collect studies on therapeutic effect of delayed autologous breast reconstruction on upper limb lymphedema from the inception to June 2020. The eligible articles were independently screened by two researchers and the data were extracted. The quality of the included literature was evaluated by the literature quality evaluation tool of the JBI, and the RevMan5.3 software was used for Meta analysis. Results Eleven articles were included, of which six were quantitative synthetic analysis. Meta analysis showed that 64.8%(95% confidence interval, 0.32~0.88) of the patients reduced lymphedema after breast reconstruction whether they received lymph node transplantation or not. Subgroup analysis showed that 84.4% (95% confidence interval, 0.72~0.92) of patients reduced lymphedema after breast reconstruction and lymph node transplantation,while only 21.9%(95% confidence interval,0.14~0.33) reduced lymphedema after breast reconstruction. Conclusion Delayed autologous breast reconstruction can improve upper limb lymphedema in patients with breast cancer, and lymph node transplantation may be the largest contributing factor leading to lymphedema improvement.

Key words: breast reconstruction, breast cancer, lymphedema, Meta analysis

中图分类号: 

  • R473.73
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