乳腺癌病人上肢淋巴水肿的多因素分析  

A multiple variable analysis about the risk factors of breast cancer related arm lymphedema

作　　者：黄关立[1] 吕世旭[1] 郝儒田[1] 张筱骅[1] 

机构地区：[1]浙江省温州医学院附属第一医院肿瘤外科,浙江温州325000

出　　处：《外科理论与实践》2011年第1期39-41,共3页Journal of Surgery Concepts & Practice

基　　金：温州市科技计划项目(Y20080081)

摘　　要：目的:研究可以手术的乳腺癌病人治疗后,患侧上肢淋巴水肿的发生率及危险因素。方法:回顾性分析408例乳腺癌病人术后患侧上肢淋巴水肿的发生情况,对其潜在危险因素,包括年龄、体质量指数、肿块大小、淋巴结转移情况、腋窝处理方式、乳腺处理方式、有无合用放疗和(或)化疗,进行了多因素Logistic回归分析。结果:408例乳腺癌病人术后的患侧上肢淋巴水肿发生率为24.0%。多因素分析结果表明,相对于体质量指数<25,体质量指数≥25的OR值(相对危险度)为2.492,95%CI(可信区间)为1.445～4.299;相对腋窝无操作者,腋窝淋巴结清扫的OR值为4.929,95%CI为1.451～16.741;相对于无放疗者,放疗的OR值为2.266,95%CI为1.321～3.889。结论:患侧上肢淋巴水肿是乳腺癌治疗后常见的并发症,体质量指数、腋窝处理方式及放疗是其发生的危险因素。Objective To investigate the incidence and risk factors of related arm lymphoedema following radical surgery of the breast.Methods Four hundred and eight patients were retrospectively studied.Multivariate Logistic regression analysis was used in studying the potential factors,including age,body mass index（BMI）,tumor size,axillary lymph-node status,axillary management,breast procedure,radiotherapy /or chemotherapy.Results Ninety eight cases（24.0%） developed lymphoedema of the related arm.Multivariate analysis identified BMI≥25（vs.BMI 25,OR 2.492;95% CI,1.445-4.299）,axillary dissection（vs.no axillary dissection,OR 4.929;95% CI,1.451-16.741）,and radiotherapy（vs.no radiotherapy,OR 2.266;95% CI,1.321-3.889） to be independent predictors of lymphoedema.Conclusions Lymphoedema of the related arm remains to be a significant clinical problem.The results of the current study demonstrated that the risk of lymphoedema of the related arm is correlated with the BMI,the radiotherapy and axillary management undertaken.

关 键 词：上肢淋巴水肿 乳腺肿瘤 危险因素 

分 类 号：R737.9[医药卫生—肿瘤]