逆行腋窝淋巴示踪在预防腋窝清扫术后上肢水肿的应用  

Application of Retrograde Axillary Lymphatic Tracing in Preventing Up⁃per Extremity Edema after Axillary Dissection Surgery

作　　者：雷全国 李长风[1] 黄小刚 谢增丁 赵倩 LEI Quanguo;LI Changfeng;HUANG Xiaogang;XIE Zengding;ZHAO Qian(Department of General Surgery,Sixth Division Hospital of Xinjiang Production and Construction Corps,Wujiaqu,Xin-jiang Uygur Autonomous Region,831300 China)

机构地区：[1]新疆生产建设兵团第六师医院普外科,新疆五家渠831300

出　　处：《系统医学》2023年第22期125-128,共4页Systems Medicine

摘　　要：目的 分析逆行腋窝淋巴示踪在预防腋窝清扫术后上肢水肿的应用效果。方法 选取2022年1月—2023年1月新疆生产建设兵团第六师医院收治的70例乳腺癌患者为研究对象,随机数表法分为两组,每组35例,对照组采用常规腋窝清扫术,观察组给予逆行腋窝淋巴示踪术。于术后1、3、6个月评价两组上肢肿胀程度,并且术后第6个月评价两组淋巴水肿分级,对比两组术后半年水肿相关症状。结果 术后1、3、6个月,观察组患者的上臂中心周径、鹰嘴上15 cm周径水肿程度低于对照组,差异有统计学意义(P<0.05)。术后半年观察组患者的无水肿、轻度水肿比例分别为94.29%,5.71%,对照组患者的无水肿、轻度水肿比例分别为40.00%,42.86%,观察组的无水肿比例高于对照组,轻度水肿比例低于对照组,差异有统计学意义(χ^(2)=23.377、13.130、P<0.05)。术后半年观察组患者的上肢肿胀、上肢疼痛、乏力、活动受限、皮肤凹陷等维度评分均低于对照组,差异有统计学意义(P<0.05)。结论 乳腺癌腋窝清扫患者接受逆行腋窝淋巴示踪术治疗,对于预防患者腋窝清扫术后上肢水肿及并发症有临床意义。Objective To analyze the application effect of retrograde axillary lymphatic tracing in the prevention of up-per extremity edema after axillary dissection.Methods A total of 70 breast cancer patients admitted to the Sixth Divi-sion Hospital of Xinjiang Production and Construction Corps from January 2022 to January 2023 were selected as the research object and divided into two groups with 35 cases in each group by random number table method.The control group received conventional axillary dissection and the observation group received retrograde axillary lymphatic tracer.The upper limb swelling degree of the two groups was evaluated at 1,3 and 6 months after surgery,and the lymphedema grade of the two groups was evaluated at 6 months after surgery,and the edema related symptoms of the two groups were compared six months after surgery.Results At 1,3 and 6 months after operation,the edema degree of upper arm center diameter and 15 cm diameter of olecranon in observation group were lower than that in control group,and the differences were statistically significant(P<0.05).Half a year after surgery,the proportion of patients with no edema and mild edema in the observation group was 94.29%and 5.71%,respectively;the proportion of pa-tients with no edema and mild edema in the control group was 40.00%and 42.86%,respectively;the proportion of pa-tients with no edema in the observation group was higher than that in the control group,and the proportion of patients with mild edema was lower than that in the control group,and the difference was statistically significant(χ^(2)=23.377,13.130,P<0.05).6 months after surgery,the scores of upper limb swelling,upper limb pain,fatigue,limited activity and skin depression in the observation group were lower than those in the control group,and the differences were sta-tistically significant(P<0.05).Conclusion It is of clinical significance for patients with axillary dissection of breast cancer to receive retrograde axillary lymphatic tracing for the prevention of upper limb edema and co

关 键 词：乳腺癌 逆行腋窝淋巴示踪术 腋窝清扫术后 上肢水肿 

分 类 号：R714[医药卫生—妇产科学]