Abstract：
Lymphoedema is thought to affect around 200 000 people in the UK (NHS England, 2023). Secondary lymphoedema is a relatively common complication of cancer and cancer treatment, and in advanced disease it may present a challenging issue for community nursing staff caring for patients approaching the end of their lives. In this article, a case study considers the assessment and treatment of upper limb lymphoedema in a patient with advanced metastatic breast cancer. Management of this complex and distressing condition requires holistic assessment and collaborative care planning with the patient and their wider care team, including onward referral to specialist lymphoedema and palliative care services. The case study considers the typical presentation of lymphoedema in an upper limb, exclusion of reversible causes for oedema, awareness of palliative care emergencies such as superior vena cava obstruction, and the provision of supportive therapeutic interventions in context of the patient\'s expressed wishes for her ongoing care.
摘要：
淋巴水肿被认为会影响英国大约20万人(NHS英格兰，2023年）。继发性淋巴水肿是癌症和癌症治疗中相对常见的并发症，在晚期疾病中，这可能会给社区护理人员带来一个具有挑战性的问题，这些护理人员正在照顾接近生命尽头的患者。在这篇文章中,一个案例研究考虑了晚期转移性乳腺癌患者上肢淋巴水肿的评估和治疗。这种复杂而令人痛苦的疾病的管理需要与患者及其更广泛的护理团队进行整体评估和协作护理计划。包括继续转诊专科淋巴水肿和姑息治疗服务。该案例研究考虑了上肢淋巴水肿的典型表现，排除水肿的可逆原因，了解姑息治疗紧急情况，如上腔静脉阻塞，以及在患者表达对持续护理的愿望的背景下提供支持性治疗干预措施。
