专项干预对乳腺癌根治术老年患者术后凝血功能与上肢淋巴水肿的影响  

Effects of special intervention on postoperative coagulation function and upper limb lymphedema in elderly patients with radical mastectomy for breast cancer

作　　者：申华[1] 张妍妍 孙瑞姣 SHEN Hua;ZHANG Yanyan;SUN Ruijiao(Department of Critical Medicine,Zhengzhou Second Hospital,Zhengzhou 453000,He’nan,China;Department of Thyroid and Breast Surgery,Zhengzhou Second Hospital,Zhengzhou 453000,He’nan,China)

机构地区：[1]郑州市第二人民医院重症医学科,郑州453000 [2]郑州市第二人民医院甲乳外科,郑州453000

出　　处：《癌症进展》2021年第24期2582-2585,共4页Oncology Progress

摘　　要：目的探讨专项干预对乳腺癌根治术老年患者术后凝血功能与上肢淋巴水肿的影响。方法将102例乳腺癌老年患者根据干预方式的不同分为常规组与专项组,每组51例。常规组采用常规干预,专项组采用专项干预。比较两组患者干预前后的凝血功能指标[凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、纤维蛋白原(FIB)、凝血酶时间(TT)、D-二聚体(D-D)],血清炎性因子水平[C反应蛋白(CRP)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)],统计两组患者术后下肢深静脉血栓形成(DVT)、上肢淋巴水肿发生率。结果干预后,两组患者PT、APTT、TT均明显延长,FIB、D-D水平均明显降低,专项组PT、APTT、TT均明显长于常规组,FIB、D-D水平均明显低于常规组,差异均有统计学意义(P﹤0.01)。干预后,两组患者CRP、IL-6、TNF-α水平均明显降低,且专项组均明显低于常规组,差异均有统计学意义(P﹤0.01)。专项组术后上肢淋巴水肿、DVT发生率均低于常规组,差异均有统计学意义(P﹤0.05)。结论专项干预可改善患者术后的凝血功能指标及血清炎性因子水平,降低乳腺癌根治术老年患者术后下肢DVT、上肢淋巴水肿发生率。Objective To investigate the effect of the special intervention on postoperative coagulation function and upper limb lymphedema in elderly patients receiving radical mastectomy for breast cancer.Method A total of 102 elder-ly patients with breast cancer were divided into routine group and special group according to different intervention meth-ods,51 cases in each group.The routine group adopted routine intervention,while the special group adopted special inter-vention.The coagulation function indicators[prothrombin time(PT),activated partial thromboplastin time(APTT),fibrin-ogen(FIB),thrombin time(TT),D-dimer(D-D)],serum inflammatory factor levels[C-reactive protein(CRP),interleu-kin6(IL-6),tumor necrosis factor-α(TNF-α)]of the two groups of patients before and after the intervention were com-pared.The incidences of lower extremity deep vein thrombosis(DVT)and upper limb lymphedema in the two groups of patients were counted and analyzed.Result After intervention,PT,APTT,and TT in the two groups were significantly prolonged,and the levels of FIB and D-D were significantly decreased;the PT,APTT,and TT in the special group were significantly longer than those in the routine group,and the levels of FIB and D-D in the special group were significantly lower than those in the routine group,the differences were statistically significant(P<0.01).After intervention,the levels of CRP,IL-6,and TNF-αin the two groups were significantly decreased,and the levels of CRP,IL-6,and TNF-αin spe-cial group were significantly lower than those of routine group,the differences were statistically significant(P<0.01).The incidences of upper limb lymphedema and DVT in the special group were lower than those in the routine group,the differ-ences were statistically significant(P<0.05).Conclusion Special intervention could improve postoperative levels includ-ing coagulation function indicators and serum inflammatory factors,reduce the incidence of DVT and upper limb lymph-edema in elderly patients after radical mastectomy.

关 键 词：乳腺癌根治术 老年 凝血功能 上肢淋巴水肿 

分 类 号：R737.9[医药卫生—肿瘤]