《中国康复理论与实践》

《中国康复理论与实践》 ›› 2014, Vol. 20 ›› Issue (2): 105-108.

• 论文 • 上一篇    下一篇

乳腺癌不同术式后患肢功能障碍对比分析

张锋良，龙志华，高飞，孙海晨，徐青   

  1. 1.首都医科大学康复医学院，北京市100068；2.中国康复研究中心北京博爱医院普通外科，北京市100068；3.首都医科大学宣武医院普外科，北京市100053。
  • 收稿日期:2013-09-06 修回日期:2013-11-27 出版日期:2014-02-25 发布日期:2014-02-25
  • 通讯作者: 徐青

Comparative Analysis of Limb Dysfunction in Different Surgical Breast Cancer

ZHANG Feng-liang, LONG Zhi-hua, GAO Fei, et al.   

  1. Capital Medical University School of Rehabilitation, Department of General Surgery, Beijing Bo'ai Hospital, China Rehabilitation Research Center, Beijing 100068, China
  • Received:2013-09-06 Revised:2013-11-27 Published:2014-02-25 Online:2014-02-25

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被引次数

11

摘要： 目的比较乳腺癌不同术式后患肢活动、感觉障碍、淋巴水肿的发病情况，评价患肢功能障碍发病的临床相关因素。方法2005 年~2012 年235 例乳腺癌患者按腋窝淋巴结处理术式不同分为腔镜腋窝淋巴结清扫组(A组，n=120)和常规腋窝淋巴结清扫组(B 组，n=115)。测量患者患侧上肢肩关节前屈、后伸、外展、内收活动度，并与对侧比较；测量双上肢尺骨鹰嘴上下15 cm的周径，随访患者术后半年、1 年、2 年患肢功能障碍的发病情况。结果两组患者术后半年、1 年、2 年患肢在肩关节活动、感觉方面(麻木和疼痛)无显著性差异(P>0.05)；B组患肢水肿的发病率高于A组(P<0.05)。放疗与患肢淋巴水肿有关联(P<0.05)。结论腔镜腋窝淋巴结清扫术与常规腋窝淋巴结清扫术相比，能降低乳腺癌患者术后患肢淋巴水肿的发病率，但在肩关节活动、感觉障碍方面无差别。术后放疗是增加患肢淋巴水肿发生的危险因素。

关键词: 乳腺癌, 功能障碍, 腋窝淋巴结清扫, 淋巴水肿, 放射疗法

Abstract: Objective To compare the incidence of limb dysfunction, sensory disturbance and lymphedema after different treatment methods in breast cancer patients, and evaluate the clinically relevant factors of limb dysfunction. Methods According to the different processing operation of axillary lymph nodes, 235 patients with breast cancer during 2005 to 2012 were divided into axillary lymph node dissection group in Mastoscopy (group A, n=120) and routine axillary lymph node dissection group (group B, n=115). The flexion, extension, abduction, adduction activity of the ipsilateral shoulder were compared with the contralateral, and the circumference of the up-and-down 15 cm of both upper limbs olecroanon were measured. The incidence of limb dysfunction of the patients was followed up in 6 months, 1 year and 2 years. Results There was no significant difference in limb activity and sensory disturbance between 2 groups 6 months, 1 year and 2
years after operation (P>0.05), the incidence of limb lymphedema was higher in group B than in group A (P<0.05). Radiotherapy was related with limb lymphedema in both groups (P<0.05). Conclusion Compared with the conventional axillary lymph node dissection, endoscopic axillary lymph node dissection can reduce the incidence of limb lymphedema after operation, but there was no significant difference in the limb activity and sensory disturbance between 2 groups. Postoperative radiotherapy is a risk to increase the occurrence of limb lymphedema.

Key words: breast cancer, dysfunction, axillary lymph node dissection, lymphedema, radiotherapy