乳腺癌患者假体植入乳房重建术后患肢功能康复现状及影响因素  

Status of functional rehabilitation of affected limbs and influencing factors of breast cancer patients after breast reconstruction with prosthesis implantation

作　　者：吴娟 郭丝锦 郭程程 王廷 WU Juan;GUO Sijin;GUO Chengcheng;WANG Ting(Department of Thyroid and Breast Surgery,the First Affiliated Hospital of Air Force Medical University,Shaanxi Province,Xi’an 710000,China)

机构地区：[1]空军军医大学第一附属医院甲乳血管外科,陕西西安710000

出　　处：《中国医药导报》2024年第36期114-121,共8页China Medical Herald

基　　金：陕西省自然科学基础研究计划重点项目(2021 JZ-29)。

摘　　要：目的探讨乳腺癌患者假体植入乳房重建术后患肢功能康复现状及影响因素。方法选取2022年1月至2023年1月空军军医大学第一附属医院收治的106例拟行假体植入乳房重建术治疗的乳腺癌患者作为研究对象。于术后3个月使用上肢功能评定量表(DASH)、自我接纳问卷(SAQ)、乳腺癌患者报告结局量表(BREAST-Q)及医学应对问卷(MCMQ)评估患者的患侧上肢功能、自我接纳水平、生活质量水平、满意度及应对方式,分析不同临床特征患者的SAQ、DASH评分差异及自我接纳水平与对患侧上肢功能康复的影响。结果共纳入106例患者,DASH总评分为(50.35±5.26)分,其中日常生活功能评分为(39.52±2.51)分,上肢症状评分为(10.25±1.62)分;SAQ总评分为(35.62±2.15)分,其中自我评价维度评分为(16.53±3.01)分,自我接纳维度评分为(15.92±2.41)分。不同年龄、文化程度、有无配偶、康复治疗介入时间、应对方式、社会心理健康、身体健康、性健康、乳房外观满意度患者DASH总评分比较,差异有统计学意义(P<0.05);不同文化程度、有无配偶、康复治疗介入时间、应对方式患者SAQ总评分比较,差异有统计学意义(P<0.05)。经双变量Pearson相关性检验显示,DASH总评分及其日常生活功能维度、上肢症状维度评分与SAQ总评分及自我接纳维度、自我评价维度评分均呈负相关(r<0,P<0.05)。经多元线性回归分析显示,康复治疗介入时机、应对方式、有无配偶、SAQ总评分、文化程度、社会心理健康、身体健康、性健康及乳房外观满意度是患者患侧上肢功能康复效果的影响因素(P<0.05)。结论乳腺癌患者假体植入乳房重建术后上肢功能恢复水平仍有待提高,自我接纳水平,康复治疗介入时机、应对方式、有无配偶、文化程度、社会心理健康、身体健康、性健康及乳房外观满意度影响患者患侧上肢功能康复效果。Objective To explore the status of functional rehabilitation of affected limbs and influencing factors of breast cancer patients after breast reconstruction with prosthesis implantation.Methods From January 2022 to January 2023,106 patients with breast cancer who planned to undergo breast reconstruction with prosthesis implantation in the First Affiliated Hospital of Air Force Medical University were selected as the study subjects.The disability of arm-shoulder hand(DASH),self-acceptance questionnaire(SAQ),breast cancer patient-reported outcome scale(BREAST-Q),and medical coping modes questionnaire(MCMQ)were used to evaluate the affected upper limb function,self-acceptance level,quality of life level,satisfaction,and coping style of the patients at three months after operation.The differences of SAQ and DASH scores in patients with different clinical characteristics and the influence of self-acceptance level on the rehabilitation of upper limb function were analyzed.Results A total of 106 patients were included,with a total DASH score of(50.35±5.26)points,including a daily life function score(39.52±2.51)points and an upper limb symptom score(10.25±1.62)points.The total score of SAQ was(35.62±2.15)points,self-evaluation dimension score(16.53±3.01)points and self-acceptance dimension score(15.92±2.41)points.There were statistical significant differences in the DASH total scores of patients with different age,levels of education,spouse status,rehabilitation intervention time,coping strategies,social and psychological health,physical health,sexual health,and breast appearance satisfaction(P<0.05).There were statistical significant differences in the SAQ total scores of patients with different levels of education,spouse status duration of rehabilitation treatment intervention,and coping styles(P<0.05).The bivariate Pearson correlation test showed that the total score of DASH and its dimension of daily life function,upper limb symptom dimension score were negatively correlated with the total score of SAQ,self-acc

关 键 词：乳腺癌 假体植入乳房重建术 自我接纳 应对方式 上肢功能评定量表 

分 类 号：R655[医药卫生—外科学]