乳腺癌淋巴结清扫术中保留上肢淋巴结的疗效分析

发布时间：2018-01-19 08:19

本文关键词： 乳腺癌淋巴结清扫术淋巴水肿生活质量　出处：《中国现代医学杂志》2017年29期 　论文类型：期刊论文

【摘要】：目的在探讨乳腺癌淋巴结清扫术中保留上肢淋巴结对淋巴水肿及生活质量的影响。方法选取2013年1月-2014年12月于贵州省人民医院乳腺科收治的100例T1-3No Mo期乳腺癌患者,根据患者及其家属协商选择的手术方法将研究对象分为观察组和对照组,每组各50例。观察组术前以纳米炭混悬液行经上臂逆行腋窝淋巴结示踪术;对照组行腋窝淋巴结清扫术。于术后1、6及12个月时对两组患者进行随访,记录并比较两组患者随访期间各时间点患侧比健侧上肢臂围增加的百分比,术后12个月时上肢淋巴水肿发生情况,各时间点乳腺癌患者生命质量测定量表(FACT-B)评分。结果两组术后1、6及12个月患侧比健侧上肢臂围增加的百分比比较,差异有统计学意义(P0.05)。此外,两组12个月时上肢淋巴水肿总发生率比较,差异有统计学意义(P0.05);在预防上肢淋巴水肿的效果方面,观察组的优良率高于对照组(P0.05)。与治疗前相比,观察组的生活质量评分降低,且两组随访期间各时间点的评分比较,差异有统计学意义(P0.05)。结论保留上肢淋巴结的乳腺癌淋巴结清扫术可以有效地预防患者上肢淋巴水肿,改善患者的生活质量,值得在临床上推广使用。
[Abstract]:The quality of life and effects of retaining the edema of upper limb lymph nodes in the lymph to investigate lymph node dissection in breast cancer. Methods from January 2013 -2014 year in December in the breast Department of Guizhou People's Hospital from 100 cases of T1-3No patients with stage Mo breast cancer patients and their families, according to the consultation operation methods selected subjects were divided into observation group and control group. 50 patients in each group. The patients of the observation group with carbon nanoparticles suspension arm underwent retrograde axillary lymph node tracer technique; the control group underwent axillary lymph node dissection. After 1,6 and 12 months of two groups were recorded and recorded during percentage were compared between the two groups at each time point with follow-up side than the healthy side upper limb arm circumference increased, after 12 months of surgery of upper extremity lymphedema incidence scale measuring quality of life in patients with breast cancer at each time point (FACT-B) score. The results of two groups of 1,6 and 12 months after the affected side than The contralateral upper arm circumference increased the percentage of comparison, the difference was statistically significant (P0.05). In addition, the two groups at 12 months of upper limb lymphedema incidence of comparison, the difference was statistically significant (P0.05); in the prevention of upper extremity lymphedema, observation group good rate higher than the control group (P0.05). Compared with before treatment, life quality scores in the observation group decreased, and the two groups during follow-up at each time point were compared, the difference was statistically significant (P0.05). Conclusion preservation of upper limb lymph node of breast cancer lymph node dissection can effectively prevent upper extremity lymph edema patients, improve the quality of life of patients, is worthy to be popularized in clinical.

【作者单位】：贵州省人民医院乳腺外科;
【基金】：贵州省科学技术基金项目[No:黔科合J字(2009)2200号]
【分类号】：R737.9
【正文快照】： 乳腺癌是女性最常见的恶性肿瘤之一。据统计,每年10万名女性中就新增81.1例乳腺癌患者,5年生存率为82%[1]。对于乳腺癌的治疗,乳腺癌根治术一直是主流的治疗手段之一[2]。但是患者术后同侧上肢淋巴水肿的发生率较高,达7%[3]。以往的研究发现,与腋窝淋巴结清扫(axillary lymph

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