核素–染料双示踪法在乳腺癌前哨淋巴结活检术中的围术期舒适护理实践及效果分析
Perioperative Comfort Nursing Practice and Effect of Radionuclide-Dye Dual Tracer Method in Sentinel Lymph Node Biopsy of Breast Cancer Breast Disease Department

目的：探讨核素(99mTc-硫胶体)联合亚甲蓝双示踪法下乳腺癌前哨淋巴结活检术(SLNB)围术期舒适护理的应用效果。方法：采用前瞻性对照研究，选取2023年4月~2024年3月行双示踪法SLNB的60例乳腺癌患者，随机分为观察组(标准化舒适护理，n = 30)与对照组(常规护理，n = 30)。观察组实施放射性防护教育、过敏反应预警、动态体位管理等干预措施，对照组按常规流程护理。比较两组术后24小时静息疼痛评分(VAS)、焦虑水平(HADS量表)及护理满意度(Likert 5级量表)。结果：观察组术后VAS评分显著低于对照组(2.35 ± 0.72 vs 4.12 ± 1.05, t = 8.23, P < 0.001)，焦虑评分较术前下降33.8% (5.20 ± 1.05 vs 7.85 ± 1.32, t = 4.76, P < 0.001)，且术后满意度评分(95.64 ± 2.54)显著高于对照组(88.52 ± 4.65, t = 8.52, P < 0.001)。对照组上述指标改善均无统计学意义(P > 0.05)。结论：核素–染料双示踪技术围术期舒适护理可有效缓解患者术后疼痛及焦虑，提升护理满意度，其技术特异性措施(如放射防护标准化、体位动态调整)具有临床推广价值。
Objective: To investigate the effect of perioperative comfort nursing in breast cancer sentinel lymph node biopsy (SLNB) with 99MTC-sulfur gel combined with methylene blue double tracer method. Methods: A prospective controlled study was conducted to select 60 patients with breast cancer who underwent double tracer SLNB from April 2023 to March 2024 and were randomly divided into observation group (standardized comfort care, n = 30) and control group (conventional care, n = 30). The observation group received radiological protection education, anaphylaxis early warning, dynamic position management and other intervention measures, while the control group received nursing care according to routine procedures. Resting pain score (VAS), anxiety level (HADS scale) and nursing satisfaction (Likert 5-level scale) were compared between the two groups 24 hours after surgery. Result: The VAS score of the observation group was significantly lower than that of the control group (2.35 ± 0.72 vs 4.12 ± 1.05, t = 8.23, P < 0.001), and the anxiety score was decreased by 33.8% (5.20 ± 1.05 vs 7.85 ± 1.32, t = 4.76, P < 0.001). The postoperative satisfaction score (95.64 ± 2.54) was significantly higher than that of the control group (88.52 ± 4.65, t = 8.52, P < 0.001). There was no statistical significance in the improvement of the above indexes in control group (P > 0.05). Conclusion: Radionuclide-dye dual tracer technique can effectively relieve postoperative pain and anxiety and improve nursing satisfaction, and its technology-specific measures (such as standardization of radiological protection and dynamic adjustment of body position) have clinical value.