乳腺癌术后PMPS发生情况及影响因素分析  

Occurrence and Influencing Factors of PMPS After Breast Cancer Surgery

作　　者：景晓杰 姜文翰 刘志敏 周峰 魏路宽[1] JING Xiaojie;JIANG Wenhan;LIU Zhimin(Henan Provincial Chest Hospital,Zhengzhou,450000)

机构地区：[1]河南省胸科医院,450000

出　　处：《实用癌症杂志》2023年第5期863-866,共4页The Practical Journal of Cancer

摘　　要：目的分析乳腺癌术后疼痛综合征(PMPS)发生情况及其影响因素,以减轻乳腺癌患者术后疼痛。方法回顾性分析行手术治疗的180例乳腺癌患者的临床相关资料,并统计术后PMPS的发生率以及患者疼痛部位、疼痛性质;按是否发生PMPS分组,收集患者临床相关资料,Logistic逐步回归法分析乳腺癌术后PMPS发生的危险因素。结果乳腺癌术后发生PMPS患者38例,发生率为21.11%,以患侧腋窝疼痛(55.26%)最常见,且疼痛以麻木为主(42.11%);其中术后发生PMPS患者纳入观察组,142例未发生PMPS患者纳入对照组;两组临床相关资料、病情、治疗比较,身体质量指数(BMI)、文化程度、婚姻状况、手术方式、术后化疗差异均无统计学意义(P>0.05),但观察组年龄小于对照组(P<0.05),焦虑抑郁、肿瘤位于上象限、腋窝淋巴结清扫、术后进行放疗的比率均高于对照组(P<0.05);多因素Logistic逐步回归分析显示:患者年龄、腋窝淋巴结清扫、肿瘤部位、术后放疗是影响乳腺癌患者术后疼痛综合征发生的危险因素(P<0.05)。结论乳腺癌术后并发PMPS的发生率较高,主要以患侧腋窝疼痛、麻木为主,患者年龄、心理状态、肿瘤位于上象限、术中进行腋窝淋巴结清扫、术后进行放疗是术后并发PMPS的独立因素,值得临床重视。Objective To analyze the occurrence and influencing factors of post-mastectomy pain syndrome(PMPS)after breast cancer surgery so as to alleviate postoperative pain in breast cancer patients.Methods Clinical data of 180 breast cancer patients who underwent surgery were analyzed retrospectively.The incidence of PMPS,location and nature of pain were analyzed.According to the presence or absence of PMPS,the patients were grouped.Logistic regression analysis was performed to screen the risk factors of PMPS after breast cancer surgery.Results 38 patients developed PMPS after breast cancer surgery,with an incidence of 21.11%.Axillary pain was the most common(55.26%),and dominated by numbness(42.11%).Patients who developed PMPS were included in the observation group,and 142 patients without PMPS were included in the control group.Comparison of relevant clinical data,condition and treatment between groups found that there was no statistically significant difference in body mass index(BMI),degree of education,marital status,surgical method or postoperative chemotherapy(P>0.05),but patients in the observation group were younger than those in the control group(P<0.05).The proportions of patients with anxiety and depression,tumor located in the upper quadrant,axillary lymph node dissection,and postoperative radiotherapy in the observation group were higher than those in the control group(P<0.05).Multivariate logistic stepwise regression analysis showed that patient age,axillary lymph node dissection,tumor location,and postoperative radiotherapy were risk factors for PMPS in breast cancer patients(P<0.05).Conclusion The incidence of PMPS is relatively high after breast cancer surgery.Axillary pain and numbness are main manifestations.Patient age,psychological status,tumor location in the upper quadrant,intraoperative axillary lymph node dissection,and postoperative radiotherapy are independent factors for PMPS,which deserves attention.

关 键 词：乳腺癌术 术后放疗 年龄 腋窝淋巴清扫 肿瘤部位 疼痛综合征 

分 类 号：R737.9[医药卫生—肿瘤]