乳腺癌术后上肢淋巴回流改变的危险因素分析  

Risk factors for lymphatic drainage change in the upper limb after breast cancer surgery

作　　者：刘畅[1] 李珺[1] 骆浩[1] 侯建新[1] 牛家宁 宋雨书 赵海东[1] Liu Chang Li Jun Luo Hao Hou Jianxin Niu Jianing Song Yushu Zhao Haidong(Department of Breast Surgery, Second Hospital of Dalian Medical University, Dalian 116021, China)

机构地区：[1]大连医科大学附属第二医院乳腺外科,116021

出　　处：《中华内分泌外科杂志》2016年第5期360-364,共5页Chinese Journal of Endocrine Surgery

基　　金：大连市科技局国际合作项目（2015F11GH097）

摘　　要：目的探讨乳腺癌术后继发上肢淋巴回流改变的相关危险因素。方法2014年5月至2015年5月共117例行乳腺癌手术。对其患侧上肢采用近红外荧光成像法造影，其结果根据Yamamoto评判方法进行判定。通过Logistic回归方式对比分析术侧继发上肢淋巴水肿的危险因素。结果117例中36例淋巴回流发生改变，发生率为30．8％（36／117）。其与高BMI、放疗、行腋窝淋巴结清扫（axillary lymph node dissection，ALND）呈正相关性（P〈0．05）。结论高BMI、放疗、行ALND为乳腺癌术后上肢淋巴回流改变的危险因素。年龄及优势手臂与乳腺癌术后上肢淋巴回流改变发生无关。Objective To investigate the risk factors of secondary upper limb lymph circulation pattern after breast cancer surgery. Methods 117 cases undergoing breast cancer surgery from May 2014 to May 2015 were studied. Circumferential fluorescent images of lymphatic drainage channels were obtained by an near in- frared fluorescence imaging system. Characteristic findings were analyzed according to Yamamoto evaluation method. Logistic multivariate regression analysis was used to analyze the risk factors of secondary lymphedema. Results 36 out of the 117 patients had lymph flow changes, and the incidence was 30.8% （36/117）. Surgery- related lymphedema was positively correlated with obesity, radiotherapy, and axillary lymph node dissection （AL- ND） （P〈0.05）. Conclusion Significant related factors are： obesity, radiotherapy, ALND, while age, and advan- tage arm are not related to arm dermal backflow pattern.

关 键 词：乳腺癌 淋巴水肿 吲哚菁绿增强淋巴管造影 上肢淋巴回流模式 

分 类 号：R737.9[医药卫生—肿瘤]