医学临床研究
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医学临床研究  2020, Vol. 37 Issue (1): 56-59    DOI: 10.3969/j.issn.1671-7171.2020.01.018
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选择性保留腋窝淋巴结对乳腺癌患者术后早期淋巴性水肿发生的影响
廖瑜玲, 黄庆炜, 戴丽娜
惠州市第一人民医院乳腺外科,广东 惠州 516001
Effect of Selective Axillary Lymph Node Preservation on Early Postoperative Lymphedema in Patients with Breast Cancer
LIAO Yu-ling, HUANG Qing-wei, DAI Li-na
Department of breast surgery,Huizhou first people's hospital,Huizhou city516001,Guangdong province,China
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摘要 【目的】 探讨选择性保留腋窝淋巴结对乳腺癌患者术后早期淋巴性水肿发生的影响。【方法】 选择2013年5月至2016年2月本院收治的136例早期乳腺癌患者,根据术中是否选择性保留腋窝淋巴结将患者将其分为逆行腋窝淋巴结示踪术(ARM)组(n=70,观察组)和腋窝淋巴结清扫(ALND)组(n=66,对照组)。所有患者术后随访6个月,对比两组患者淋巴水肿发生情况,以及预防水肿的效果。于术后1周(T0)、1个月(T1)和 6个月(T2)对比两组患者术后患侧上臂中点周径(MP)、鹰嘴上15 cm周径(C-15)、两者总和(SUM)较健侧增加百分比,应用乳腺癌淋巴性水肿问卷(LBCQ)、乳腺癌生活质量测评量表(FACT-B)评价T0~T2基线患者淋巴水肿严重程度和生活质量。【结果】 两组患者术后患侧MP、C-15、SUM较健侧增长百分比均逐渐下降(P<0.05),观察组患者患侧MP、C-15、SUM较健侧增长百分比在T0~T2时处均低于对照组(P<0.05)。两组患者术后LBCQ评分逐渐下降(P<0.05),FACT-B评分逐渐上升(P<0.05),观察组于T0~T2时LBCQ评分均低于对照组(P<0.05),FACT-B评分均高于对照组(P<0.05)。观察组患者术后6个月上肢水肿发生率为7.14%(5/70)低于对照组的24.24%(16/66),差异有统计学意义(χ2=4.204,P=0.04<0.05)。观察组患者预防水肿优良率为88.57%(62/70)高于对照组的69.70%(46/66),差异有统计学意义(χ2=7.402,P=0.007<0.05)。【结论】 选择性保留腋窝淋巴结可预防和降低早期乳腺癌患者术后上肢淋巴性水肿的发生和水肿程度,提高术后生活质量。
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廖瑜玲
黄庆炜
戴丽娜
关键词 乳腺肿瘤/外科学淋巴水肿/病因学淋巴结    
Abstract【Objective】To discuss the effect of selective axillary lymph node retention on early postoperative lymph node edema in breast cancer patients.【Methods】From May 2013 to February 2016, 136 patients with early breast cancer were divided into two groups: arm group (n=70, observation group) and ALND group (n=66, control group). All patients were followed up for 6 months. The occurrence of lymphedema and the effect of prevention were compared between the two groups. One week (T0), one month (T1) and six months (T2) after operation, MP, C-15 and the SUM of the two groups were compared. Lbcq and FACT-B were used to evaluate the severity and quality of life of the patients at T0~T2 baseline. 【Results】The increase percentage of MP, C-15 and SUM in the affected side decreased gradually (P<0.05). The increase percentage of MP, C-15 and SUM in the observed group was lower than that in the control group at T0~T2 (P<0.05). The LBCQ score of the two groups decreased gradually (P<0.05), and the FACT-B score increased gradually (P<0.05). The LBCQ score of the observation group was lower than that of the control group at T0~T2 (P<0.05), and the FACT-B score was higher than that of the control group (P<0.05). The incidence of upper extremity edema was 7.14% (5 / 70) in the observation group and 24.24% (16 / 66) in the control group 6 months after operation, the difference was statistically significant (χ2 = 4.204,P=0.04<0.05). The excellent and good rate of edema prevention in the observation group was 88.57% (62/70) higher than that in the control group 69.70% (46 / 66). The difference was statistically significant (χ2=7.402,P=0.007<0.05).【Conclusion】Selective preservation of axillary lymph nodes can prevent and reduce the incidence and degree of postoperative lymphedema in the upper extremity of patients with early breast cancer, and improve the quality of life after operation.
Key wordsBreast Neoplasms/SU    lymphedema/ET    Lymph nodes
收稿日期: 2018-07-23     
PACS:  R737.9  
基金资助:惠州市科技计划(编号:2018Y102)
引用本文:   
廖瑜玲, 黄庆炜, 戴丽娜. 选择性保留腋窝淋巴结对乳腺癌患者术后早期淋巴性水肿发生的影响[J]. 医学临床研究, 2020, 37(1): 56-59.
LIAO Yu-ling, HUANG Qing-wei, DAI Li-na. Effect of Selective Axillary Lymph Node Preservation on Early Postoperative Lymphedema in Patients with Breast Cancer. JOURNAL OF CLINICAL RESEARCH, 2020, 37(1): 56-59.
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http://journal07.magtech.org.cn/yxlcyj/CN/10.3969/j.issn.1671-7171.2020.01.018     或     http://journal07.magtech.org.cn/yxlcyj/CN/Y2020/V37/I1/56
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