针对乳腺癌患者术后上肢淋巴水肿筛查的效果观察  

Effect of Screening for Lymphedema in Patients after Breast Cancer Surgery

作　　者：张星[1] 彭昕[1] 胡洁[1] 郭潇[1] 包莹琦[1] ZHANG Xing;PENG Xin;HU Jie(Union Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan,430014,China)

机构地区：[1]华中科技大学同济医学院附属协和医院肿瘤中心

出　　处：《中国社会医学杂志》2019年第5期556-559,共4页Chinese Journal of Social Medicine

基　　金：湖北省科技厅知识创新专项项目(2017CFB453)

摘　　要：目的探讨开展淋巴水肿筛查在乳腺癌患者术后上肢淋巴水肿的实施效果。方法选取某三甲医院2015年6月—2017年6月确诊为乳腺癌并行腋窝淋巴结清扫术的住院患者共890例,按手术时间先后分为对照组440例和观察组450例。对照组给予常规的淋巴水肿相关知识宣教及护理,观察组在给予同样的知识宣教和护理的基础上,对其进行上肢淋巴水肿的筛查。对两组检出率及检出结果进行统计学分析。结果观察组筛查出上肢淋巴水肿48人,检出率为10.7%,其中轻度淋巴水肿13人(27.1%),中度淋巴水肿19人(39.5%),重度淋巴水肿16人(33.4%);对照组筛查出上肢淋巴水肿10人,检出率为2.3%,其中轻度淋巴水肿1人(10%),中度淋巴水肿3人(33.4%),重度淋巴水肿6人(56.6%)。两组比较,差异有统计学意义(P<0.05),观察组轻中度水肿检出率显著高于对照组(P<0.05)。结论通过上肢淋巴水肿的筛查,有利于早期发现并有效减少乳腺癌上肢淋巴水肿并发症的发生、发展,有利于提高淋巴水肿筛查检出率,并提高患者就诊意识,其不失为一种切实可行的筛查方法。Objective To observe the effect of screening for lymphedema in upper extremity lymphedema after mastectomy.Methods A total of 890 inpatients with axillary lymph node dissection from June 2015 to June 2017 were selected,and then divided into control group(440 cases)and observation group(450 cases).The control group received the usual care and the knowledge of lymphedema.In addition,the observation group screened all inpatients for upper limb lymphedema.The detection rate and detection results of the two groups were statistically analyzed.Results The observation group screened 48 patients with upper limb lymphedema,the detection rate was 10.7%,including 13 cases had mild lymphedema(27.1%),19 cases had moderate lymphedema(39.5%),and 16 cases had severe lymphedema(33.4%).The control group screened 10 patients with upper limb lymphedema,the detection rate was 2.3%,including 1 case with mild lymphedema(10%),3 cases with moderate lymphedema(33.4%),and 6 cases with severe lymphedema(56.6%).The difference between the two groups was statistically significant( P <0.05),and the detection rate of mild to moderate edema in the observation group was significantly higher than that in the control group( P <0.05).Conclusion Through the screening of upper limb lymphedema,early detection is beneficial and could reduce the occurrence and development of complications of upper limb lymphedema of breast cancer,improve the detection rate of lymphedema screening and the patients' awareness of treatment.It is a practical screening method.

关 键 词：乳腺癌 淋巴水肿 筛查 

分 类 号：R737.9[医药卫生—肿瘤]