目的 介绍淋巴康复护理工作室的构建过程,分析评价工作室的运行效果,为探索淋巴康复护理新模式提供依据。方法 成立以淋巴康复护理专家为领军人的淋巴康复护理工作室,组建以淋巴水肿专科护士为主导的多学科团队,为淋巴水肿患者提供规范化的保守治疗、多形式的健康教育及延续护理等服务内容,并开展人才培养、教学、科研创新等工作。结果 淋巴康复护理工作室建立以来,工作量平均年增长率稳定在15%以上,并根据患者需求逐年开展新业务;对123例在工作室进行规范化综合消肿疗法保守治疗且完成6个月后复查的淋巴水肿患者数据进行统计分析,结果表明,患肢与健肢周径差平均值、身体总水分和患肢阶段水分比较差异有统计学意义(P<0.05)。淋巴康复专科护理人才队伍得以扩大,课题、论文、专利等科研产出得以提升。结论 淋巴康复护理工作室的建立满足了患者多元化的治疗需求,并为专科护士的发展提供了平台,有助于促进学科发展,具有推广价值。
Abstract
Objective To introduce the construction of lymphatic rehabilitation nursing studio, and to analyze and evaluate the operation effect of the studio. Methods The studio with lymphatic rehabilitation nursing experts as leaders was established, and a multidisciplinary team led by lymphoedema specialist nurses provided services including standardized CDT, multiform health education and continuous nursing care. Corresponding talent cultivation, teaching, scientific research and innovation were conducted. Results Since the establishment of the studio, the average annual workload growth rate has remained stable at over 15%, with new services being introduced annually based on patient needs; analysis of the data of 123 patients who underwent standardized CDT and were reviewed six months after the treatment showed that the average difference in circumference between the affected limb and the healthy limb, total body water, and the difference in segment moisture of the affected limb show statistically significant differences (P<0.05). The team of lymphatic rehabilitation nursing professionals has been expanded, and there were more scientific research outputs such as projects, papers and patents. Conclusion The establishment of lymphatic rehabilitation nursing studio meets the diversified treatment needs of patients, and provide a platform for the development of nurse specialists, which contributes to the advancement of the discipline and is worth to be promoted.
关键词
淋巴水肿 /
护理工作室 /
康复护理 /
护理管理
Key words
lymphedema /
nursing studio /
rehabilitation nursing /
nursing management
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参考文献
[1] Brix B, Sery O, Onorato A,et al.Biology of Lymphedema[J].Biology (Basel),2021,10(4).DOI:10.3390/biology10040261.
[2] 孔为民,张赫.妇科肿瘤治疗后下肢淋巴水肿专家共识[J].中国临床医生杂志,2021, 49(2):149-155.DOI: 10.3969/j.issn.2095-8552.2021.02.006.
[3] 沈傲梅,路潜,符鑫,等.基于前瞻性队列研究的Meta分析构建乳腺癌相关淋巴水肿风险预测模型研究[J].中国全科医学,2023, 26(17):2078-2088.DOI: 10.12114/j.issn.1007-9572.2022.0827.
[4] Dessources K,Aviki E,Leitao M J.Lower extremity lymphedema in patients with gynecologic malignancies[J].Int J Gynecol Cancer,2020,30(2):252-260.DOI:10.1136/ijgc-2019-001032.
[5] 刘媛媛,刘高明,胡进,等.子宫内膜癌治疗后外阴淋巴水肿患者症状体验与心理感受的质性研究[J].护理学报,2022,29(21):1-5.DOI:10.16460/j.issn1008-9969.2022.21.001.
[6] 刘宁飞. 淋巴水肿——诊断与治疗[M].北京:科学出版社,2014.
[7] 常鲲,夏松,孙宇光,等.联合应用抽吸减容术与淋巴静脉吻合术治疗下肢继发性淋巴水肿的临床效果[J].中华外科杂志,2017,55(4):274-278.DOI:10.3760/cma.j.issn.0529-5815.2017.04.008.
[8] Armer J M, Ostby P L, Ginex P K, et al.ONS Guidelines for Cancer Treatment-Related Lymphedema[J]. Oncol Nurs Forum,2020,47(5):518-538.DOI:10.1188/20.ONF.518-538.
[9] 肖永凤,王光扬.徒手淋巴引流技术临床应用研究进展[J].护理学报,2024,31(12):32-36.DOI:10.16460/j.issn1008-9969.2024.12.032.
[10] 赵慧慧,周春兰,吴艳妮,等.乳腺癌相关淋巴水肿患者运动指导方案的证据总结[J]. 中华护理杂志,2020,55(5):779-785.DOI: 10.3761/j.issn.0254-1769.2020.05.030.
[11] 刘梦迪,张振美,高倩,等.妇科肿瘤术后下肢淋巴水肿患者抗阻力运动相关证据总结分析[J].齐鲁护理杂志,2023,29(6):67-72.DOI: 10.3969/j.issn.1006-7256.2023.06.022.
[12] 魏亚培,王婷婷,陈滢滢,等.胸导管探查术后综合消肿治疗对双下肢淋巴水肿患者的短期效果[J].组织工程与重建外科,2023,19(3):249-252.DOI: 10.3969/j.issn.1673-0364.2023.03.006.
[13] 王玲,尚少梅,陈可欣,等.不同强度抗阻训练在乳腺癌相关淋巴水肿患者中的应用进展[J].护理实践与研究, 2022,19(16):2441-2445.
[14] 王玲,王海燕,王婷婷,等.乳腺癌相关淋巴水肿空气波压力治疗的最佳证据总结[J].中华护理杂志, 2022, 57(11):1384-1390.DOI: 10.3969/j.issn.1672-9676.2022.16.014.
[15] 王玲,尚少梅,王海燕,等.继发性淋巴水肿患者皮肤护理的最佳证据总结[J].护理学杂志,2021,36(9):102-105.DOI: 10.3870/j.issn.1001-4152.2021.09.102.
[16] 刘艳飞,刘均娥,麦艳华,等.乳腺癌康复者预防上肢淋巴水肿运动处方的设计与实施[J].中国护理管理,2021,21(2):181-186.DOI: 10.3969/j.issn.1672-1756.2021.02.005.
[17] 刘英,李群,吕大鹏,等.有氧运动联合康复护理干预在乳腺癌术后淋巴水肿的应用效果[J].中华损伤与修复杂志(电子版),2021,16(2):170-174.DOI: 10.3877/cma.j.issn.1673-9450.2021.02.016.
[18] Jiang X, Nicolls M R,Tian W,et al.Lymphatic Dysfunction,Leukotrienes,and Lymphedema[J].Annu Rev Physiol,2018,80:49-70.DOI:10.1146/annurev-physiol-022516-034008.
[19] 李彩宏,沈犁,吕茵茵.糖尿病个案管理护理工作室的构建与运行效果评价[J].中国护理管理,2021,21(8):1135-1140.DOI: 10.3969/j.issn.1672-1756.2021.08.004.
[20] 韩斌如,董婷婷,李秋萍,等.糖尿病足护理工作室的探索与实践[J].中国护理管理,2020,20(10):1444-1448.DOI: 10.3969/j.issn.1672-1756.2020.10.002.
[21] 深圳市卫生健康委员会.深圳市医疗保障局关于印发深圳市专科护士培训和管理办法的通知[EB/OL].(2023-09-14)[2024-02-22]. http://wjw.sz.gov.cn/gkmlpt/content/10/10835/post_10835117.html#25177.
基金
北京市属医院科研培育计划项目(PX2022028)