| Purpose:The Delphi method was used to conduct expert investigations on the prevention and treatment of postoperative lymphatic edema of tumors.It can initially formulate the operating specification of the Chinese medicine wax advancing technique for prevention of lymphatic edema after tumor surgery,and provide comprehensive therapy for the prevention and treatment of postoperative lymphedema of tumors.Material and method:Through searching a large number of ancient and modern literature and extensively summarizing the experience of clinical experts,we have obtained data on traditional Chinese medicine application law and systematic evaluation of lymphatic edema after breast cancer surgery for traditional Chinese medicine,and evaluated Chinese medicine treatment of postoperative lymphatic edema of breast cancer.Effect,and the initial formation of traditional Chinese medicine treatment of breast cancer after lymphatic edema,the level of clinical evidence and recommended intensity,the formation of a pre-questionnaire.According to the analysis and analysis of the pre-questionnaires,they grasped the direction and focus and formed a formal questionnaire.Delphi's expert survey questionnaire was used for statistical analysis.The writing group evaluates the effectiveness,safety,practicability,and economic efficiency of the standard.In the country,more than 30 experts in various medical institutions,such as traditional Chinese medicine or integrated Chinese and Western medicine oncology,surgery,radiotherapy,gynecology,etc.,Expert opinion collection was conducted.After the first round of questionnaires were collected,the statistical analysis of the questionnaires of the experts in the research group was statistically analyzed.We will continue to explore the issue of effective preservation and remove the problem of greater variability so as to form a second round of questionnaires.After the second round of expert questionnaires were collected,the research team then statistically analyzed the results of the second round of questionnaires.When the consensus of experts is reached,the next round of questionnaires will not be conducted.Data was entered using an Excel spreadsheet,statistical analysis was performed using SPSS 21.0 statistical software,and descriptive analysis was used to statistically analyze data from the scales.Mainly from the degree of expert opinion concentration(mean X,grade and W standard deviation S and insignificant percentage R),the degree of coordination of expert opinion(coefficient of variation CV),the degree of coordination and the reliability of the questionnaire C,etc.,according to mathematical statistics Analysis of the results of the summary of expert opinions,summed up the "Chinese medicine treatment of disease is not technical operating specifications of Chinese medicine wax promotion method" standard.Results:The Cronbaeh's coefficient ? of the first round of expert survey questionnaires was 0.96,indicating that the internal consistency of the questionnaire was high and the credibility was high.The second round of surveys was further discussed on the basis of the first questionnaire.The expert questionnaire recovery rate is 100%,and the expert's positive coefficient is 100%.The second round of expert transfer letter Cronbaeh's coefficient ? is 0.97,indicating that the questionnaire has high internal consistency and high credibility.Through the analysis of the questionnaire,the standard content was obtained: 1 The Chinese herbal tincture was rubbed in the upper limbs or lower limb lymph nodes.The Chinese herbal tinctures were Astragalus,Millettia,Safflower,Chuanxiong and Borneol at a dose of 3:3:2:2:1.Made,the best operating time is 30 min.2Preparation technique for lymphatic drainage in healthy areas(manual lymphatic drainage pretreatment).The best operation time for the upper limb was 35 minutes and the lower limb was 45 minutes.The order of manual lymphatic drainage was healthy side ? affected side,torso ? limb,proximal side of affected side stroking ? distal side ? proximal side operation.The principle of operation is to gently rub the skin,gently and gently move the surface of the skin to feel moving,uniform force.3 wax therapy and limb lymphatic drainage.The application temperature of the wax pad is maintained at 42°C-45°C,and the optimum thickness of the sterile gauze pad is 0.5 cm.After manual pretreatment with lymphatic drainage,manual lymphatic drainage of the affected limbs was performed simultaneously with heat treatment of the main lymph node area with paraffin.4 bandages for elastic bandages.Immediately after manual drainage,elastic bandage dressing is needed.Select a low elastic bandage to wrap from the distal end of the limb to the proximal end.After the tumor completely heals,the wound begins to use elastic bandages or elastic sleeves(socks)each time 12 are used.Hours,once daily use.Wear after getting up in the morning and take off at night.Elastic bandage therapy should be performed in the order of wearing a tubular bandage,then a soft pad,and finally an elastic bandage.This combination therapy is performed 20 times per session,once daily.If patients with lymphedema after surgery have reasonable health care during the first year,this comprehensive therapy can be performed once a quarter.Conclusion:The Delphi method was used to investigate the treatment of lymphatic edema after tumor surgery.After discussing and establishing the operation specification of the Chinese medicine wax-advancing push-up method to prevent postoperative lymphatic edema of tumors,applicable diseases and contraindications were determined.This operating specification has been publicly promulgated by the Chinese Association of Chinese Medicine and has a clinically significant preventive significance. |
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