术后早期、阶段性功能锻炼对乳腺癌改良根治术后患侧上肢功能恢复的影响

发布时间：2018-10-13 20:00

【摘要】：目的探讨术后早期、阶段性功能锻炼对乳腺癌改良根治术后患侧上肢功能恢复的影响。方法收集该院2013年1月至2016年6月收治的乳腺癌患者100例,所有患者均行乳腺癌改良根治术,术后将患者分为观察组和对照组,各50例。观察组给予早期、阶段性功能锻炼,对照组给予常规护理。观察两组患者肩膀关节活动度、患肢水肿程度、焦虑自评量表(SAS)评分、抑郁自评量表(SDS)评分和36项简明健康状况调查量表(SF-36)生存质量评分。结果与对照组比较,观察组患者术后3、6个月时前屈、外展、内旋、外旋、内收和后伸等肩关节活动度均明显增大(P0.05)。两组术前患侧上肢容积、SAS及SDS评分比较,差异均无统计学意义(P0.05)。与对照组比较,观察组患者术后3个月患侧上肢容积明显减小[1 543.38±414.93)mL vs.(1 635.58±401.58)mL,P=0.000];术后6个月SAS评分明显降低[(37.87±6.90)分vs.(44.07±12.32)分,P=0.000],SDS评分明显降低[(38.32±6.65)分vs.(45.02±11.07)分,P=0.000],生存质量评分明显增加[(77.52±7.28)分vs.(70.28±7.55)分,P=0.000]。结论术后早期、阶段性功能锻炼有助于改善乳腺癌改良根治术后患者的肩关节活动度和生存质量,并减轻患肢水肿程度。
[Abstract]:Objective to investigate the effect of early stage functional exercise on the recovery of upper limb function after modified radical mastectomy for breast cancer. Methods 100 patients with breast cancer were collected from January 2013 to June 2016. All patients were treated with modified radical mastectomy. The patients were divided into observation group and control group (50 cases each). The observation group was given early and periodic functional exercise, while the control group was given routine nursing. The range of motion of shoulder joint, degree of edema of affected limbs, (SAS) score of self-rating anxiety scale, (SDS) score of self-rating depression scale and 36 quality of life scores of SF-36 were observed. Results compared with the control group, the range of motion of the shoulder joint in the observation group increased significantly at 3 and 6 months after operation (P0.05), including flexion, abduction, internal rotation, external rotation, adduction and extension (P0.05). There was no significant difference in preoperative upper limb volume, SAS and SDS scores between the two groups (P0.05). Compared with the control group, the upper limb volume of the affected side significantly decreased [1 543.38 卤414.93) mL vs. (1 635.58 卤401.58 mL,P=0.000], the SAS score significantly decreased (37.87 卤6.90) vs. (44.07 卤12.32), the SDS score significantly decreased [(38.32 卤6.65) vs. (45.02 卤11.07), P0. 000], the quality of life score increased significantly (77.52 卤7.28) vs. (70.28 卤7.55), P0. 000] in the observation group 3 months after operation. Conclusion early postoperative functional exercise is helpful to improve the range of shoulder motion and quality of life of patients with breast cancer after modified radical mastectomy and reduce the degree of edema of affected limbs.
【作者单位】：杭州市淳安县第一人民医院普外科;
【基金】：2013年省卫生厅适宜技术科技项目(2013ZHA010)
【分类号】：R473.73

【参考文献】