关键词: 徒手淋巴引流；乳腺癌相关淋巴水肿；Meta分析

Abstract: Objective: To systematically evaluate the effect of Manual Lymphatic Drainage (MLD) on the prevention and treatment of Breast Cancer Related Lymphedema (BCRL), and provide high-quality evidence for the rational development of Breast Cancer Related Lymphedema prevention and treatment programs. Methods: The data were retrieved of randomized controlled trials (RCTs) about the effect of MLD on prevention and treatment of BCRL from PubMed, EMBASE, The Cochrane Library, CMB and CNKI databases from inception to Mar,2018. Two independent evaluators screened and evaluated the quality of the study according to the inclusion and exclusion criteria of the study. RevMan5.3 software was used for Meta analysis. Results: A total of 9 RCT studies involving 1 112 patients were included.Meta analysis results showed that the effect of MLD on BCRL prevention was statistically significant compared with other measures [OR=0.31, 95%CI (0.12,0.83), Z=2.33, P=0.02]. The effect of MLD on treatment of BCRL was not statistically significant compared with other measures [SMD=0.17, 95%CI (-0.08,0.41), Z=1.34, P=0.18] [WMD=-0.21, 95%CI (-1.54,1.12), Z=0.31, P=0.76]. The evidence intensity of prevention of BCRL by MLD was moderate. The strengths of two evidences for MLD treatment of BCRL were moderate and low, respectively. Conclusion: Existing evidence shows that compared with other nursing methods, MLD can effectively prevent the occurrence of BCRL, but cannot effectively treat the swelling degree of BCRL patients' limb, and the pain relief effect on the affected limb is not good. Clinical nurses should guide the patients to carry out MLD at the early stage after breast cancer surgery, and manage the patients after surgery using comprehensive nursing measures, so as to improve their health outcomes and improve their quality of life.

Key words: Manual Lymph Drainage; Breast Cancer Related Lymphedema; Meta analysis