乳腺癌根治术加放射治疗后上肢并发症的临床分析  

Complication in the arm after radical mastectomy combined with postoperative radiotherapy

作　　者：季永领[1] 田野[1] 陆雪官[1] 范秋虹[1] 杨劲松[1] 许昌韶[1] 

机构地区：[1]苏州大学附属第二医院放射治疗科,215004

出　　处：《中华放射肿瘤学杂志》2004年第3期201-204,共4页Chinese Journal of Radiation Oncology

摘　　要：目的了解乳腺癌根治手术加放射治疗患者上肢并发症的发病情况及其影响因素。方法对于接受根治或改良根治术后加放射治疗且放射治疗后已超过1年(中位数2.8年)的74例乳腺癌患者,从症状和体征两个方面进行了观测,并应用多因素回归分析相关的发病因素。结果患者上肢水肿的发生率在症状和体征检查中均约为50%,肩关节功能下降分别为49%和58%,患者年龄和全腋窝照射是发生上肢水肿与肩关节运动障碍的独立影响因素。结论上肢水肿和肩关节运动障碍是乳腺癌根治性手术加放射治疗后较常见的并发症,腋窝处理中减少正常组织的损伤以预防或降低其发生率,应该予以高度重视。Objective To determine the prevalence and prognosticators of complications in the arm after radical mastectomy followed by radiotherapy in the treatment of breast cancer. Methods The symptoms and signs of arm edema and shoulder joint dysfunction, were recorded and classified in 74 breast cancer patients treated with radical or modified radical mastectomy and postoperative radiotherapy. The duration of follow up was at least over 1 year after radiotherapy with a median of 2.8 years. Multivariate analysis was performed using binary logistic regression. Results The incidences of complaint and positive physical findings of lymphatic obstructive edema were both about 50% in all patients. And the morbidity of dysfunction of the shoulder joint was 49% and clinical signs was 58%. Multivariate analysis revealed that the relative risk of arm complications was increased obviously in the elderly women and patients who had received whole axillary irradiation. Conclusions Impaired lymphatic drainage and compromised shoulder motion are common and formidable complications after radical mastectomy followed by radiotherapy, which emphasizes the importance of further efforts to lessen the invasive procedures in the axillary treatment of breast cancer.

关 键 词：并发症 放射治疗 患者 上肢水肿 乳腺癌根治术 腋窝 症状和体征 结论 中位数 目的 

分 类 号：R737.9[医药卫生—肿瘤] R735[医药卫生—临床医学]