北京市大兴区人民医院 妇产科, 北京, 102600
收稿:2025-10-02,
修回:2026-01-07,
录用:2026-01-08,
网络首发:2026-02-28,
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宋丹, 王瑶. 基于规范化框架的新辅助化疗后三阴性乳腺癌患者围术期个性化护理1例[DB/OL].中西医结合临床案例库, 2026.
SONG Dan, WANG Yao. A Case of Perioperative Personalized Nursing for Triple-Negative Breast Cancer Patients after Neoadjuvant Chemotherapy Based on a Standardized Framework[DB/OL].Clinical Archives of Integrative Medicine, 2026.
宋丹, 王瑶. 基于规范化框架的新辅助化疗后三阴性乳腺癌患者围术期个性化护理1例[DB/OL].中西医结合临床案例库, 2026. DOI: 10.12209/CAIM202510020001.
SONG Dan, WANG Yao. A Case of Perioperative Personalized Nursing for Triple-Negative Breast Cancer Patients after Neoadjuvant Chemotherapy Based on a Standardized Framework[DB/OL].Clinical Archives of Integrative Medicine, 2026. DOI: 10.12209/CAIM202510020001.
目的
2
总结新辅助化疗后乳腺癌患者行乳房切除联合皮瓣修补术的围术期个性化护理经验,为同类复杂病例的护理提供参考。
方法
2
选取我院2024年07月收治的1例左乳腺浸润性导管癌ⅡA期患者为研究对象,该患者经6周期新辅助化疗后,因皮肤弹性下降、皮下组织纤维化,行左侧乳房切除术+左侧前哨淋巴结活检术+皮瓣修补术;围术期实施以皮瓣血运维护、患肢分级康复、疼痛情志双干预为核心的个性化护理方案,包括术前体质调理与心理疏导、术后精细化伤口护理、分阶段患肢功能锻炼及角调式五行音乐联合镇痛干预。
结果
2
患者术后未发生皮瓣坏死、患肢肿胀及感染等并发症,住院时长较同类手术平均时长缩短2 d;出院时患肢肩关节外展达90°、上举至120°,数字疼痛评分法(NRS)评分从4分降至1分,生活自理能力恢复至术前水平。
结论
2
针对新辅助化疗后乳腺癌患者的病理生理特点,实施个体化围术期护理方案,可有效降低护理风险、加速患者康复,具有较高的临床推广价值。
Objective
2
To summarize the perioperative personalized nursing experience for breast cancer patients undergoing mastectomy combined with flap repair after neoadjuvant chemotherapy, and to provide a reference for the nursing of similar complex cases.
Methods
2
A patient with left breast invasive ductal carcinoma stage IIA admitted to our hospital in July 2024 was selected as the research subject. After 6 cycles of neoadjuvant chemotherapy, the patient underwent left mastectomy + left sentinel lymph node biopsy + flap repair due to decreased skin elasticity and subcutaneous tissue fibrosis. A personalized nursing plan centered on maintaining flap blood supply, graded rehabilitation of the affected limb, and dual intervention for pain and emotions was implemented during the perioperative period, including preoperative physical conditioning and psychological counseling, postoperative meticulous wound care, staged functional exercises of the affected limb, and combined pain intervention with pentatonic music therapy.
Results
2
The patient did not experience complications such as flap necrosis, affected limb swelling, or infection after surgery. The hospital stay was 2 days shorter than the average for similar surgeries. At discharge, the shoulder joint abduction of the affected limb reached 90°, and the shoulder joint elevation reached 120°. The Numerical Rating Scale (NRS) score decreased from 4 to 1, and the patient's self-care ability returned to the preoperative level.
Conclusion
2
Implementing individualized perioperative nursing plans based on the pathophysiological characteristics of breast cancer patients after neoadjuvant chemotherapy can effectively reduce nursing risks and accelerate patient recovery, and has high clinical promotion value.
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