乳腺癌改良根治术后上肢淋巴水肿与腋窝淋巴结阳性率的相关性分析  

Correlation analysis of upper extremity lymphedema and axillary lymph node positive rate after modified radical mastectomy for breast cancer

作　　者：唐小乔[1] 苏磊[1] 桑剑锋[1] Tang Xiaoqiao;Su Lei;Sang Jianfeng(Gulou Hospital affiliated to Medical College of Nanjing University,210093)

机构地区：[1]南京大学医学院附属鼓楼医院普外科

出　　处：《中华普外科手术学杂志（电子版）》2020年第1期74-77,共4页Chinese Journal of Operative Procedures of General Surgery(Electronic Edition)

摘　　要：目的探讨分析乳腺癌改良根治术后上肢淋巴水肿与腋窝淋巴结阳性率的相关性。方法对2014年11月至2016年11月进行改良根治术治疗的112例乳腺癌患者进行回顾性研究,依据周径测量法对患者淋巴水肿状况进行测量,将未出现水肿患者作为对照组,出现水肿患者列入水肿组,应用SPSS18.0进行分析,对两组患者上肢淋巴水肿与腋窝淋巴结阳性率进行Logistic单因素与多因素分析,两组患者术后上肢淋巴水肿症状对比采用χ2检验,P<0.05差异有统计学意义。结果经单因素分析结果显示,患者体质指数、淋巴结转移、术后并发症、瘤体大小、放射治疗与上肢淋巴水肿、腋窝淋巴结阳性率有关(P<0.05);经多因素分析上肢淋巴水肿的独立危险因素为:体质指数、年龄、放射治疗(P<0.05);通过对比,水肿组上肢肿胀感与沉重感发生率显著高于对照组(P<0.05)。结论导致乳腺癌患者术后出现上肢淋巴水肿的独立危险因素诸多,应当对出现的危险因素给予高度重视,采取相应措施来降低上肢淋巴水肿的发生率。Objective To investigate the correlation between upper limb lymphedema and axillary lymph node positive rate after modified radical mastectomy.Methods A retrospective study was performed on 112 patients with breast cancer who underwent modified radical mastectomy from November 2014 to November 2016.The patient’s upper limb lymphedema was measured according to the circumferential diameter measurement method,and the patients without edema appeared as the control group.Patients with edema were included in the edema group,and SPSS18.0 was used for analysis.Logistic single factor and multivariate analysis were performed on the positive rate of upper limb lymphedema and axillary lymph nodes in the two groups.The symptoms of upper limb lymphedema in the two groups were compared withχ2.P<0.05 difference was statistically significant.Results The results of single factor analysis showed that there were correlations between body mass index,lymph node metastasis,postoperative complications,tumor size,radiotherapy and upper limb lymphedema,and axillary lymph node positive rate(P<0.05).Multi-factor analysis of upper limb lymphedema showed that the independent risk factors were:body mass index,age,radiation therapy.(P<0.05).By contrast,the incidence of upper limb swelling and heavy feeling in the edema group was significantly higher than that in the control group(P<0.05).Conclusion There are many independent risk factors for upper limb lymphedema in patients with breast cancer.The risk factors should be highly valued.The relevant programs should be developed for treatment and corresponding measures should be taken to reduce the incidence of upper limb lymphedema.

关 键 词：乳腺肿瘤 乳房切除术 改良根治性 淋巴水肿 

分 类 号：R73[医药卫生—肿瘤]