“手势类比法”在乳腺癌患者术后护理中的应用

2021
11/26

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NursingResearch护理研究前
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乳腺癌是威胁妇女健康的最常见的恶性肿瘤。

Dear editor,

Breast cancer is the most common malignancy threatening women's health. In recent years, the incidence of breast cancer in China has been increasing year by year. The latest data on global cancer in 2020 show that breast cancer has been the first cancer, so the diagnosis and treatment situation of breast cancer is still significant. Surgery is the primary treatment option for breast diseases. With the development of science and the progress of medical technology, the diagnostic methods of breast diseases update, and the surgical methods improve constantly. Postoperative care of breast cancer is also becoming more and more significant. For newly enrolled nursing students, only when they are familiar with postoperative complications of breast cancer, can patients get better care. Recently, the “Gesture Analogy Method” developed by the orthopedic team of our hospital is widely used not only in surgery teaching but also in nursing teaching.1,2 The purpose of this study is to combine the “Gesture Analogy Method” with postoperative complications of breast cancer, to make the complex learning content simple, and to help students memorize and understand.

One of the complications after breast cancer surgery is upper extremity lymphedema. The axillary lymph nodes of the breast divide into five groups, apical lymph node group: located in the axillary apex, above the upper edge of pectoralis minor muscle, arranged along the axillary vein near the heart end; central lymph node group: located in the center of the axilla and the loose connective tissue behind and below the axillary vessels, it is the largest lymph node group in the axilla; lateral lymph node group: located in the lateral wall of the axilla, arranged along the distal end of the axillary vein; posterior lymph node group: situated in the lateral axillary wall, from the thoracic wall to the axillary vein level along the subscapular vessels, so it calls subscapular lymph nodes; anterior lymph node group: located in the medial wall of the axilla, the lower margin of the pectoralis minor muscle, and the superficial surface of the 2nd to 4th ribs, arranged along the lateral thoracic vessels, also known as pectoralis lymph nodes (Figure A). For nursing students, the first step is to determine the severity of edema. Mild edema means that the circumference length of the upper limb on the affected side is less than 3.5 cm compared with the circumference length of the upper limb on the opposite side, severe edema is more than 5 cm, moderate edema is between 3.5 cm and 5 cm. If we find the patient has upper limb edema symptoms after surgery, the patient should exercise in time. The exercise method divide into three stages, the first stage for hand, wrist, elbow joint exercise; The second stage is the exercise of shoulder joint; The third stage mainly practiced lifting the affected limb (Figure B).

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The “Gesture Analogy Method” helps students find the fun of learning. In short, the “Gesture Analogy Method” can be widely used in nursing teaching.

Funding

The author has no fund support.

Declaration of competing interest

All authors have no potential conflicts of interest to disclose.

Acknowledgements

We are particularly grateful to our Orthopedics colleagues for their contributions to the Affiliated Hospital of Inner Mongolia Medical University.

全文翻译(仅供参考)

亲爱的编辑。

乳腺癌是威胁妇女健康的最常见的恶性肿瘤。近年来,我国乳腺癌的发病率逐年上升。2020年全球癌症的最新数据显示,乳腺癌已经成为第一大癌症,因此,乳腺癌的诊断和治疗形势依然严峻。手术是乳腺疾病的主要治疗方案。随着科学的发展和医疗技术的进步,乳腺疾病的诊断方法不断更新,手术方法也不断改进。乳腺癌的术后护理也越来越有意义。对于刚入学的护生来说,只有熟悉乳腺癌的术后并发症,患者才能得到更好的护理。最近,我院骨科团队开发的 "手势比喻法 "不仅在外科教学中得到了广泛的应用,而且在护理教学中也得到了应用。1,2本研究的目的是将 "手势比喻法 "与乳腺癌术后并发症相结合,使复杂的学习内容简单化,帮助学生记忆和理解。

乳腺癌手术后的并发症之一是上肢淋巴水肿。乳房的腋窝淋巴结分为五组,顶端淋巴结组:位于腋窝顶点,胸小肌上缘上方,沿腋窝静脉近心端排列;中央淋巴结组:位于腋窝中央和腋窝血管后方及下方的疏松结缔组织,是腋窝内最大的淋巴结组;外侧淋巴结组。位于腋窝外侧壁,沿腋静脉远端排列;后部淋巴结群:位于腋窝外侧壁,从胸壁到腋静脉水平沿肩胛下血管排列,故称为肩胛下淋巴结;前部淋巴结群。位于腋窝内侧壁、胸小肌下缘、第2~4肋骨浅面,沿胸腔外侧血管排列,又称胸大肌淋巴结(图A)。对于护理学生来说,第一步是确定水肿的严重程度。轻度水肿是指患侧上肢的周长与对侧上肢的周长相比小于3.5厘米,重度水肿超过5厘米,中度水肿在3.5厘米至5厘米之间。如果我们发现患者术后有上肢水肿的症状,患者应及时进行锻炼。锻炼方法分为三个阶段,第一阶段为手、腕、肘关节的锻炼;第二阶段为肩关节的锻炼;第三阶段主要练习抬起患肢(图B)。

手势类比法 "可以帮助学生找到学习的乐趣。总之,"手势类比法 "可以在护理教学中广泛使用。

资助

作者没有资金支持。

竞争性利益声明

所有作者没有潜在的利益冲突需要披露。

鸣谢

我们特别感谢内蒙古医科大学附属医院骨科的同事,感谢他们的贡献。


原文链接:

https://doi.org/10.1016/j.asjsur.2021.10.027

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关键词:
乳腺癌,breast,cancer,The,护理

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