评估自制的新型肢体围长测量尺在乳腺癌术后患者肢体测量中的应用效果。

根据纳入及排除标准，纳入2021年1~5月北京医院甲状腺乳腺疝外科的乳腺癌术后患者100例进行前瞻性研究。每位患者均由护士和患者本人使用传统软尺和新型测量尺进行上臂围的测量。测量结束后，所有患者均填写笔者自制的体验调查问卷。探讨同一部位2种方法的测量值的相关性采用Pearson相关性分析。测量时间、问卷评分的比较采用配对t检验。不同方法的独立完成情况比较用Kappa检验，居家使用意向比较用配对χ²检验。

患者及护士采用新型测量尺与传统软尺测量上臂围的相关性均较好(肘上r＝0.847、0.752，肘下r＝0.667、0.859；P均<0.001)。患者与护士使用新型测量尺的测量时间均低于传统软尺[患者：(13.22±6.13)s比(76.66±36.22)s，t＝－18.681，P<0.001；护士：(11.03±1.74)s比(14.25±1.69)s，t＝－16.541，P<0.001]。患者使用新型测量尺的独立完成情况优于传统软尺(Kappa＝0.011，95%CI：－0.001~0.022，P＝0.410)。患者对新型测量尺的总体印象、难易程度、满意度评分均高于传统软尺(t＝－18.986、－18.855、－21.732，P均<0.001)。愿意居家使用新型测量尺的患者比例高于传统软尺(97%比12%，χ²＝81.103, P<0.001)。

新型肢体围长测量尺准确性较好，操作简单、便捷，可以作为乳腺癌术后患者居家测量臂围的工具。

To evaluate the application of a self-designed ruler in limb circumference measurement of postoperative breast cancer patients.

According to the inclusion and exclusion criteria, 100 postoperative breast cancer patients treated in the Department of Thyroid, Breast and Hernia Surgery, Beijing Hospital from January to May 2021 were enrolled for a prospective study. The circumference of the upper arm was measured by the nurse and the patient separately using a normal soft ruler and this new ruler. After measurement, a survey was conducted in all patients using a self-designed questionnaire to investigate their experience. Pearson correlation analysis was used to explore the correlation between measurement values at the same site by two methods. The paired t test was used to compare the measurement time and the score in questionnaire. The Kappa test was used to analyze the independent degree of measurement in patients using different methods, and the paired χ² test was used to analyze their intention to use the new ruler at home.

The upper arm circumference measured by patients or nurses showed a high correlation using the normal ruler and this new ruler (above the elbow: r=0.847, 0.752; under the elbow: r=0.667, 0.859; all P<0.001). The measurement time using the new ruler was significantly lower than that using the normal ruler [patients: (13.22±6.13) s vs (76.66±36.22) s, t=-18.681, P<0.001; nurses: (11.03±1.74) s vs (14.25±1.69) s, t=-16.541, P<0.001]. The independent degree of measurement using the new ruler was better than that using the normal ruler (Kappa=0.011, 95%CI: -0.001-0.022, P=0.410). The scores in overall impression, operation difficulty and patient satisfaction with the new ruler were significantly higher than those with the normal ruler (t=-18.986, -18.855, -21.732, all P<0.001). The proportion of patients who were willing to use the new ruler at home was significantly higher than that of the normal rulers (97% vs 12%, χ²=81.103, P<0.001).

The new ruler has good accuracy, simple and convenient operation, and can be used as a tool for measuring arm circumference at home in postoperative patients with breast cancer.