乳癌術後淋巴水腫的預防與照護

The Prevention and Nursing Care of Lymphoedema after Breast Cancer Treatment

淋巴水腫是乳癌病患接受淋巴切除術或放射線治療後的重要合併症，此淋巴水腫的發生時間可長達術後20年，乳癌病患終其一生可能都會面臨罹患淋巴水腫的威脅。因二期以上的淋巴水腫是不可逆的，只能控制惡化，所以早期發現早期治療，是預防淋巴水腫發生的最佳方式。護理人員在照護有潛在性發生淋巴水腫病患時，除建立病患長期遵守預防措施的意識外，應從「避免受傷、預防感染」、「避免肢體壓迫」及「適度使用及運動肢體」等三方面進行衛教。期望本文對淋巴水腫病理機轉的簡介，整合文獻對淋巴水腫的預防與治療，能提昇護理人員在乳癌術後淋巴水腫的預防與照護能力。

Lymphedema is a very common and serious complication for breast cancer patients with auxiliary lymph note dissection and radio therapy. These patients could be threatened by lymphedema lifelong due to the occurrence of lymphedema can be 20 years later after treatment. “Early detection and early treatment” is the best treatment for lymphedema. Once the lymphedema developed into the second stage, its damage is irreversible. Besides acknowledge about the importance of lifelong prevention, nurses should educate patients about three important self-care methods. There are ways to prevent injury and infection, to avoid stress direct toward arm, and to mobilize arm adequately. In order to enhance clinical nurses’ competency in caring breast cancer patients with lymphedema, this paper synthesizes literatures knowledge about the mechanism of lymphedema, its prevention and nursing care.