手术设计及康复锻炼对乳腺癌患者术后患侧上肢功能康复的影响  

Effect of operation design and rehabilitation exercise on functional rehabilitation of affected limb of postoperative patients with breast cancer

作　　者：李宏江[1] 许瑞华[1] 张永琼[1] 刘红[1] 赵扬冰[1] 

机构地区：[1]四川大学华西医院普外一科,四川省成都市610041

出　　处：《中国临床康复》2004年第29期6305-6307,共3页Chinese Journal of Clinical Rehabilitation

摘　　要：目的:探寻理想的乳腺癌手术技巧和术后患侧上肢功能康复的方法,以便尽可能地保证术后患侧上肢功能的康复。方法:对520例乳癌患者从手术切口设计尽可能避免伸入腋窝、适度的腋窝清扫,并尽量保护神经,术后第天即开始进行手、腕、肘部的主动运动1(屈、伸和旋转),肩关节的小范围前屈、后伸及旋转锻炼,逐渐增加活动量,10d后开始外展肩关节,并在墙上进行摸高锻炼。及时处理并发症,放射治疗在术后3个月以后进行。术后6个月时评价并记录功能恢复满意度。结果:患肢功能恢复满意度为96.0%499/520):460例88.5%,((460/520)满意,39例7.5%,39/520)基本满意,21例4.0%,21/((520)不满意。结论:从设计治疗计划开始,就应考虑患肢功能的临床康复,并在术后指导患者进行正确的康复锻炼,使患侧上肢功能得到最大限度的康复。AIM:To find the ideal operative technique for breast cancer and the method for postoperative rehabilitation of affected limb in order to ensure the postoperative rehabilitation of affected limb of patients. METHODS:Totally 520 patients with breast cancer received operation,the incisions were designed not to extend to axillary fossa as far as possible,axillary lymph tissure were removed rationally,and nervi were protected as far as possible.Patients were permitted to move(flex,extend and rotate) the hand,the wrist and the elbow of the affected limb and flex or extend slightly the shoulder joint from the first day after operation.Ten days later,the patients were permitted to abduct shoulder joint and touch high place on the wall using hands.The complication was handled in time,and the radiotherapy was performed three months after operation.The functional rehabilitation was evaluated and the satisfactory degree was recorded six months after operation. RESULTS:There were 96.0%(499/520) patients who were satisfied to have good recovery of the affected limb function:460 cases(88.0%,460/520)satisfied,39(8.0%,39/520)basically satisfied and 21(4.0%,21/520)did not satisfy. CONCLUSION:The functional rehabilitation of affected limb should be considered at the beginning of the design of treatment.And the patients should be directed to finish the rehabilitation exercise in correct method,so the function of affected limb will be recovered as great as possible.

关 键 词：术后 上肢功能 患侧 患者 康复锻炼 乳腺癌 手术设计 时评 应考 结论 

分 类 号：R737.9[医药卫生—肿瘤] R742.3[医药卫生—临床医学]