Breast cancer lymphedema: pathophysiology and risk reduction guidelines.
Breast cancer lymphedema: pathophysiology and risk reduction guidelines.
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DOI：
10.1188/02.onf.1285-1293
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发表时间：
2002-10-01
影响因子：
1.9
通讯作者：
Ridner, Sheila H
中科院分区：
文献类型：
--
作者：
Ridner, Sheila H
目的：回顾血管-间质-淋巴管界面的正常生理学，描述乳腺癌治疗后继发淋巴水肿的病理生理学，并总结当前国家淋巴水肿网络(NLN)风险降低指南的生理学基础。DATA来源：期刊文章、解剖学和生理学教科书、已发表的研究数据和网站。DATA综合：乳腺癌治疗后发生的淋巴水肿显著影响生理、心理和性功能。大约28%的乳腺癌幸存者会出现淋巴水肿症。当动脉毛细血管滤过率超过淋巴输送能力时，就会发生淋巴水肿。NLN风险降低指南可能会降低淋巴水肿的风险。结论：淋巴水肿是慢性的，而且会造成损害。大多数NLN风险降低指南，尽管不是循证的，但都是基于合理的生理学原则。护理应用：在循证研究与NLN降低风险指南相抵触之前，护士应告知乳腺癌患者淋巴水肿的风险，降低该风险的指南，以及指南的生理基础。
PURPOSE/OBJECTIVES: To review the normal physiology of the blood capillary-interstitial-lymphatic vessel interface, describe the pathophysiology of lymphedema secondary to treatment for breast cancer, and summarize the physiologic bases of the current National Lymphedema Network (NLN) risk reduction guidelines.DATA SOURCES: Journal articles, anatomy and physiology textbooks, published research data, and Web sites.DATA SYNTHESIS: Lymphedema occurring after treatment for breast cancer significantly affects physical, psychological, and sexual functioning. About 28% of breast cancer survivors develop lymphedema. When arterial capillary filtration exceeds lymphatic transport capacity, lymphedema occurs. NLN risk reduction guidelines may decrease lymphedema risk.CONCLUSION: Lymphedema is chronic and disfiguring. Most NLN risk reduction guidelines, although not evidence-based, are based on sound physiologic principles. Evidence-based research of the effectiveness of NLN risk reduction guidelines is indicated.IMPLICATIONS FOR NURSING: Until evidence-based research contradicts NLN's risk reduction guidelines, nurses should inform patients with breast cancer about their risk for lymphedema, guidelines to reduce that risk, and the physiologic rationale for the guidelines.