不同术式对早期乳腺癌患者术后上肢功能的影响  

Influence of different operative methods on postoperative upper limb function in patients with early stage breast cancer

作　　者：马雪霞[1] 黄碧萍[1] 陈凯嘉[1] 张惠[1] 

机构地区：[1]中山大学孙逸仙纪念医院乳腺外科,广州510120

出　　处：《中国医药》2011年第2期150-151,共2页China Medicine

摘　　要：的 探讨不同术式对早期乳腺癌患者术后上肢功能的影响.方法 将2006年1月至2008年12月行前哨淋巴结活检术（SLNB）替代腋窝清扫术（ALND）的125例乳腺癌患者作为SLNB组,同一时期行ALND且术后病理淋巴结阴性的45例乳腺癌患者作为ALND组;比较2组患者术后上肢并发症的发生情况.结果 SLNB组出现麻木、肿胀、疼痛、感觉减退及僵硬的比例分别为22.5%（18/80）、5.0%（4/80）、33.8%（27/80）、15.0%（12/80）、3.8%（3/80）,均少于ALND组的78.8%（26/33）、39.4%（13/33）、54.5%（18/33）、57.6%（19/33）、18.2%（6/33）,差异有统计学意义（P＜0.05或P＜0.01）.SLNB组肌力减退中发生率为8.7%（7/80）,明显低于ALND组的42.4%（14/33）,差异有统计学意义（P＜0.01）.SLNB组的平均臂围差为（0.12±0.67）cm,与ALND的（0.86±1.13）cm相比,差异有统计学意义（P＜0.01）.结论 随着乳腺癌外科治疗的进展,保乳手术和SLNB应用于临床,使手术对上肢功能的影响逐渐减轻.同时根据不同术式制定出不同上肢功能锻炼计划,可改善患者上肢功能,提高患者生活质量.Objective To study the influence of different operative methods on postoperative upper limb function in patients with early stage breast cancer. Methods From January 2006 to December 2008,125 cases with early satge breast cancer receiving sentinel lymph node biopsy（SLNB） replacing axillary lymph node dissection （ALND） were servered as study group;45 cases receiving ALND and postoperative pathological lymph node negative were served as control group at the same time. The postoperative upper limb complications were compared between two groups. Results In SLNB group,the incidence of numbness,swelling,pain,impaired sense and stiffness was 22.5% （18/80）,5.0% （4/80）,33.8% （27/80）,15.0% （12/80）,3.8% （3/80） respectively,less than those in ALND group 78.8% （26/33）,39.4% （13/33）,54.5% （18/33）,57.6% （19/33）,18.2% （6/33） （P 〈0.05 or P〈0.01）. The incidence of myodynamic attenuation in the SLNB group was 8.7% （7/80）,significantly lower than that in ALND group42.4% （14/33） （P〈0.01）. In SLNB group,the average arm circumference difference was （0.12 ±0.67） cm,statistically lower than that in ALND group （0.86 ± 1.13） cm（P 〈0.01）.Conclusions With the progress in surgical treatment of breast cancer,breast-conserving surgery and SLNB have been applied widely,so the impact of surgery on upper limb function gradually has bean reduced. At the same time,to develop different upper limb exercise program according to different operations can improve upper limb function and quality of life.

关 键 词：乳腺肿瘤 前哨淋巴结活组织检查 功能恢复 

分 类 号：R737.9[医药卫生—肿瘤]