乳腺癌健康教育
乳腺癌健康教育
院前健康教育
(1) 乳房检查:所有成年女性,无论是否生育,都应每年一次到医院进行乳房检查。 Pre-hospital health education
(1) Breast Exams:
All adult women, regardless of whether birth or not, should go to hospital for the examination of the breasts once a year.
(2) 乳房自检:养成每月进行乳房自我检查的好习惯,具体方法如下:
①镜前检査:站立,双臂垂放两侧,观察乳房外形,注意正常的弧形轮廓是否变得不规整,有没有橘皮样的小凹点,或是有小陷窝,挤压时有无液体从乳头溢出;
②卧位检查:平躺在床上,以乳头为中心,用指腹按顺时针方向紧贴皮肤做循环按摩。检查时用力要均匀,以手指能触压到肋骨为宜。如果发现有结节、包块,需去医院做进一步检查。
(2) Breast self-exams:
Women should form the good habit of performing monthly breast self-examination, and the specific method is as follows:
(1) Mirror inspection Check: Standing and with your arms hanging on both sides, you should observe the shape of the breast, and pay attention to whether normal arc contour become irregular, whether there is orange kind of small pits or a small dimple or not. Then you can squeeze the nipples to see whether there is fluid overflow or not.
(2) Clinostatic Check: Do this check you should lie in the bed, and press your finger pulp close to your breast skin to move in a clockwise direction centering on the nipple. The strength of checking should be well-distributed with which you can just touch your ribs. If you can find a nodule, bag piece during this procedure, you need go to hospital for further examination.
(3) 养成良好的生活习惯:
①保持正常体重。
肥胖是患乳腺癌的高发因素。应尽可能减少高脂肪、高热量食物,特别是油炸食品的摄入;
(3) Forming good living habits:
①Maintaining a healthy weight.
As obesity is a high incidence of breast cancer, you should reduce the intake of high-fat, high-calorie foods, especially the Fried food as far as possible ;
②慎用激素类药物。
有的女人为了使乳房丰满而服用激素类药物,结果导致内分泌紊乱,增加乳腺疾病发生癌变的危险;
② careful hormone drugs.
In order to make a breast plump , some women take hormonal drugs, resulting in endocrine disorders, which increases the risk of breast cancer;
③保持良好心境。
忧郁、紧张等情绪会引起脂肪栓水平增加。 减少烟酒、咖啡等剌激性饮品的摄入; ③keep good state of mind
Women should keep good state of mind , due to depression, nervous mood cause an increased level of fat bolt.In the meanwhile , you should reduce the intake of the stimulation such as alcohol and tobacco, coffee drinks and so on;
④顺其自然做母亲。
调查显示,乳腺癌患者中性功能低下、高龄未婚、高龄初产、孀居者的比率明显高于其他人群。因为这类人群体内的激素水平很难维持正常,虽生育但极少哺乳或从未哺乳也使患乳腺癌的危险性明显增加。
④let it be a mother.
According to the survey, the amount of breast cancer patients who are low sexual function, older unmarried, older first-timer, widowed are significantly higher than the rest of the
population.Because hormone levels in these patients are more difficult to maintain normal.Even though having a baby or more, the women who rarely or never mammals also have an increased risk of breast cancer.
院内健康教育
(一) 疾病知识
1、病因 乳癌的病因尚不完全明了,但绝经前、后雌激素是激发乳腺癌的明显因素。此外,遗传、饮食、外界理化因素以及某些乳房良性疾病与乳癌的发生有一定关系。
Hospital health education
(a) disease knowledge
1、Etiology
The etiology of breast cancer is not yet fully understood, but before and after menopause estrogen is a obvious factor of stimulating breast cancer. In addition, genetic, diet, physical and chemical factors and certain types of breast benign diseases may have a certain relationship with breast cancer.
2、症状 乳腺癌早期表现是患侧乳房出现无痛、单发的小肿块,常是病人无意中发现。肿块质硬,表面不光滑,与周围组织分界不很清楚,在乳房内不易被推动。随着肿块增大,可引起乳房局部隆起。若累及Cooper韧带,可使其缩短而致肿瘤表面皮肤凹陷,即所谓“酒窝征”。临近乳头或乳晕的癌肿因侵入乳管使之缩短,可把乳头牵向癌肿一侧,进而可使乳头扁平、回缩、凹陷。癌块继续增大,癌细胞可阻塞皮下淋巴管,引起淋巴回流障碍,出现真皮水肿,皮肤呈“橘皮样”改变。
2、 Symptoms
The symptoms of early stage breast cancer is that patients often inadvertently find painless, single breast lump in one side breast. The mass of breast cancer is hard, with a unsmooth surface, which is having not a clear dividing line with the surrounding tissue and is not easy to be promote in the breast. As the mass increases, it can lead to breast local uplift.If ligament Cooper
involved ,the cancer mass can make tumor surface skin sag, the so-called "dimples" ,by making the ligament shorter. If the cancer mass is near the nipple and areola, the mass often make the
ductal shortened, taking the nipple to cancer and making the nipple flat or retracted.If cancer continues to increase, the cancer cells can block the subcutaneous lymph vessels and cause lymphatic circumfluence obstacle, leading to the "orange peel" change on surface skin.
3、治疗
乳腺癌的治疗方法和措施较多,目前主张采用以手术为主的综合治疗。对早期乳腺癌病人,手术治疗是首选。术前术后联合化学药物治疗、内分泌治疗、放射治疗及生物治疗。近十年来,乳腺癌患者5年生存率开始有所提高,归功于早发现、早诊断、早治疗及术后综合辅助治疗的不断完善。
3、Treatment
There are so many breast cancer treatment and measures, and using mainly surgical
comprehensive treatment is advocated at present.For early-stage breast cancer patients, surgery is the preferred, and then treatment with chemical therapy, endocrine therapy, radiotherapy and
biological therapy. In nearly a decade, the 5-year survival rate of breast cancer patients began to be improved, due to early detection, early diagnosis, early treatment and the continuous improvement of the comprehensive postoperative adjuvant therapy.
(二)术前指导
1、心理指导 乳腺癌病人术前复杂的心理变化主要表现为对癌症的否认、对手术的害怕及对术后胸部形态改变的担忧,医护人员应联合家属一同努力,关心给予患者支持和安慰,鼓励病人树立战胜疾病的信心,以良好的心态面对疾病和治疗。
(b) the Preoperative Guidance
1、Psychological Guidance
The main performance of the preoperative complex psychological changes of breast cancer patients is deny to accept the cancer, fear of surgery and the concerns about postoperative chest shape changes. In this situation, the health care workers together with the families should care the patients with support and comfort, encouraging patients to establish the confidence of conquer
disease,and a good attitude in the face of disease and treatment.
2、饮食指导 可进食高蛋白、高热量、富含维生素和膳食纤维的高营养多样化软食,为术后创面愈合创造有利条件。
3、妊娠或哺乳期的病人应立即终止妊娠或断乳,以免因激素作用活跃而加快乳腺癌的发展。
4、乳腺癌手术前的准备应按一切大手术常规,同时对患有其他严重疾病患者,术前须进行医治,以提高各主要脏器的功能储备。
2.Diet Guidance
The patients should eat food of high protein, high quantity of heat, vitamin ,high fiber and of high nutrient diversified pap, to create favorable conditions for postoperative wound healing.
3 .If the patients is pregnant or in the lactation, they shall immediately terminate pregnancy or weaning to avoid the development of breast cancer sped up by active hormone.
4.Preparation of breast cancer before surgery should be according to all the major operation routine. If the patients is suffering other serious disease at the same time , they should be healed before the operation to improve the main viscera function reserve.
(三) 术后指导
1、体位与活动指导
患者于术后6小时内枕平卧位,6小时后血压平稳可取半卧位,术后次日可在床上翻身、坐起,如无不适可行下床活动,下床时,患肢用健侧手托起或用吊带托起,防止患肢下垂。
(3) the Postoperative Guidance
Postoperative patients should keep themselves in pillow hypothesis within 6 hours, and 6 hours after, if the blood pressure is normal the patients may take half supine position,
postoperative day they can turn over, sit up in bed, also some actions out of bed is fine if the
patients feel good enough.When they are out of bed, their sick hand should be held with the contralateral hand or with the condole belt to prevent limb prolapse.
2、饮食指导 术后6小时患者如无恶心、呕吐等麻醉反应时,可正常饮食。
(1) 进多样化且营养丰富的食物,注意摄取多种维生素及微量元素,以加速伤口愈合。
(2) 忌高脂肪饮食,因脂肪餐后,脂肪酸经芳香化可转化成雌激素。
2. Diet Guidance
6 hours after, the patient without anesthesia reactions such as nausea, vomiting, can take a normal diet.
(1) Patients need take the diversification and nutritious food and pay attention to absorbing a variety of vitamins and trace elements to accelerate wound healing.
(2) Patients should avoid the high fat diet, because fat after eating can be converted into estrogen.
3、密切护理
术后密切观察患者恢复情况,关注患者患者血运情况,预防性帮助患者抬高患肢以防止水肿。注意自我保护患侧上肢,平卧时用小枕垫高患侧上肢,下床活动时用吊带托扶,需他人扶持时只能扶健侧,以防腋窝皮瓣滑动而影响愈合.
3.Close Cares
After the operation, the patients should be took close observation about their recovery, focus on limb`s blood supply situation, proactively help patients raise limb to prevent edema.The
patients should pay attention to self-protection of upper extremities, lay down with a small pillow to raise the upper extremities, ambulation in the sling up, support the healthy side when they need others` help, in case of axillary flaps sliding to avoid affecting the healing.
4、患侧上肢的功能锻炼
为减少疤痕挛缩影响患肢功能,患者应早期开始患侧上肢锻炼。术后3天内患侧上肢制动,避免外展上臂,以免腋窝皮瓣的滑动而影响愈合;术后1 ~2天可做伸指、握拳、屈腕动作;第3〜4天做曲肘动作;第5天练习患侧手掌摸对 侧肩及同侧耳廓;第7天可做肩部活动;第9 ~ 12天可锻炼抬高患侧上肢,做手指爬墙运动,初时用健侧手掌托住患侧肘部,
慢慢抬高,直至与肩平;第14天练习将患侧手掌置于颈后,开始是曲肘低头位,逐渐达抬头挺胸位。直至患侧手指能高举过头,自行梳理头发。在进行患肢锻炼时,如感到肩部疼痛,应减少活动量,待疼痛好转后再逐渐进行活动。注意循序渐进,不可活动过度。活动的原则是:患肢7天之内不上举,10天之内不外展。
出院健康教育
Health Education of leaving hospital
(1) 继续坚持进行患侧上肢功能锻炼,每日1~3次。避免劳累,循序渐进。
(2) 避免用患侧上肢搬动、提取重物,可进行日常的生活活动,如晾衣服、擦玻璃等。
(3) 不宜用患侧上肢测量血压、行静脉穿刺,避免皮肤破损, 减少感染的发生,防止肢体肿胀。
(4) 术后5年内应避免妊娠,以免促使乳癌复发或对侧发生病变。
(1) Continue to insist on one side upper limb function exercise, 1 to 3 times a day. Avoiding overworked and step by step.
(2) Avoiding using affected upper arm to move or extract heavy things, but daily life
activities is fine, such as clothes, clean the windows.
(3) Avoiding measuring blood pressure, vein puncture with the affected upper arm, and
avoiding any damage to the skin, infection and limb swelling.
(4) Pregnancy should be avoided within five years after operation, in case of breast cancer recurrence or contralateral lesion.
(5) 遵医嘱进行放疗、化疗,化疗每个月一次,连续半年。
(5) The prescribed radiotherapy, chemotherapy should be followed, and the chemotherapy once per month, six months in a row.
(6) 定期复査,一般术后6个月内每月复査一次,以后每3~6 个月检查一次。
(7) 经常进行另一侧乳腺的自我检查。
(8) 保持心情舒畅,适当进行体育锻炼或是做些家务劳动。
(6) Keeping a regular reexamination for identifying markers, the general postoperative
complex check is once a month within 6 months,but 6 months after, the check once every 3 ~ 6 months.
(7) Keeping self-examination on the other side breast regular.
(8) Keeping in a good mood and doing some proper exercise, or some housework.