乳腺癌术后肩关节能障碍的临床分析
发布时间：2018-10-26 07:05
【摘要】：目的:观察乳腺癌患者术后肩关节功能障碍的发病情况,并探讨其发生相关的影响因素。方法:对166例2010-2011年在苏州大学附属第二医院普外科接受手术治疗的初治单侧乳腺癌患者的临床资料进行回顾性分析,并采用调整的Constant Murley肩关节评分量表对患者术后的肩关节功能进行评估。乳腺癌患者肩关节功能评分量表的得分用(x?s)表示,肩关节功能分级标准:完全正常为70-75分,非常好为65-69分,良好为55-64分,一般为45-54分,低于45分则为功能极差。肩关节功能障碍影响因素的单因素分析采用差异性比较或相关性分析的方法,多因素分析采用多重线性回归分析方法。P0.05为差异具有统计学意义。结果:整组患者均为女性,乳腺癌中位发病年龄为51(25-74)岁,随访与手术中位时间间隔为57(41-73)月。入组患者的调整的CMS评分平均为(68.7±7.5)分。根据肩关节功能评分结果,乳腺癌患者术后肩关节功能完全正常的病例数有95例,占57.2%;肩关节功能非常好的有37例,占22.3%;肩关节功能良好的有26例,占15.7%;肩关节功能一般的有6例,占3.6%;仅2例(1.2%)患者出现肩关节功能极差。多因素分析发现,乳腺癌患者的发病年龄越大,其肩关节功能量表得分越低(P=0.041);同样,接受乳腺癌改良根治术和术后辅助放疗的患者,其肩关节功能量表的得分低(P0.05);而患者的受教育程度对肩关节功能量表的得分有显著的正向影响(P=0.008)。结论:乳腺癌患者术后肩关节功能障碍的发病率仍然较高,但以轻度功能障碍为主。患者的发病年龄大、受教育程度低、接受乳腺癌改良根治术及辅助性放疗是肩关节功能障碍发生的独立危险因素。
[Abstract]:Objective: to observe the incidence of shoulder dysfunction in patients with breast cancer after operation and to explore the related factors. Methods: the clinical data of 166 patients with primary unilateral breast cancer received surgical treatment in the second affiliated Hospital of Suzhou University from 2010 to 2011 were retrospectively analyzed. The function of shoulder joint after operation was evaluated by modified Constant Murley shoulder scoring scale. The score of shoulder function scale for breast cancer patients is expressed by (xs). The standard of shoulder function grading is 70-75 points for complete normal, 65-69 points for very good, 55-64 points for good, 45-54 points for general. Lower than 45 points for the function of the extremely poor. The single factor analysis of shoulder dysfunction was analyzed by the method of difference comparison or correlation analysis, and the multivariate analysis by multiple linear regression analysis. P0.05 was statistically significant. Results: all the patients were female. The median age of breast cancer was 51 (25-74) years. The median interval between follow-up and operation was 57 (41-73) months. The adjusted CMS score was (68.7 卤7.5) points. According to the results of shoulder function score, there were 95 cases (57.2%) with normal shoulder function after breast cancer, 37 cases (22.3%) with excellent shoulder function. 26 cases (15.7%) had good function of shoulder joint, 6 cases (3.6%) had normal function of shoulder joint, and only 2 cases (1.2%) had extremely poor function of shoulder joint. Multivariate analysis showed that the older the age of onset of breast cancer, the lower the score of shoulder function scale (P0. 041). Similarly, the patients receiving modified radical mastectomy and postoperative adjuvant radiotherapy had lower scores of shoulder function scale (P0.05), while the education level of patients had a significant positive effect on the score of shoulder joint function scale (P0. 008). Conclusion: the incidence of shoulder dysfunction in patients with breast cancer is still high, but mild dysfunction is the main disease. The patients were older and less educated. Modified radical mastectomy and adjuvant radiotherapy were independent risk factors for shoulder dysfunction.
【学位授予单位】：苏州大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R737.9
[Abstract]:Objective: to observe the incidence of shoulder dysfunction in patients with breast cancer after operation and to explore the related factors. Methods: the clinical data of 166 patients with primary unilateral breast cancer received surgical treatment in the second affiliated Hospital of Suzhou University from 2010 to 2011 were retrospectively analyzed. The function of shoulder joint after operation was evaluated by modified Constant Murley shoulder scoring scale. The score of shoulder function scale for breast cancer patients is expressed by (xs). The standard of shoulder function grading is 70-75 points for complete normal, 65-69 points for very good, 55-64 points for good, 45-54 points for general. Lower than 45 points for the function of the extremely poor. The single factor analysis of shoulder dysfunction was analyzed by the method of difference comparison or correlation analysis, and the multivariate analysis by multiple linear regression analysis. P0.05 was statistically significant. Results: all the patients were female. The median age of breast cancer was 51 (25-74) years. The median interval between follow-up and operation was 57 (41-73) months. The adjusted CMS score was (68.7 卤7.5) points. According to the results of shoulder function score, there were 95 cases (57.2%) with normal shoulder function after breast cancer, 37 cases (22.3%) with excellent shoulder function. 26 cases (15.7%) had good function of shoulder joint, 6 cases (3.6%) had normal function of shoulder joint, and only 2 cases (1.2%) had extremely poor function of shoulder joint. Multivariate analysis showed that the older the age of onset of breast cancer, the lower the score of shoulder function scale (P0. 041). Similarly, the patients receiving modified radical mastectomy and postoperative adjuvant radiotherapy had lower scores of shoulder function scale (P0.05), while the education level of patients had a significant positive effect on the score of shoulder joint function scale (P0. 008). Conclusion: the incidence of shoulder dysfunction in patients with breast cancer is still high, but mild dysfunction is the main disease. The patients were older and less educated. Modified radical mastectomy and adjuvant radiotherapy were independent risk factors for shoulder dysfunction.
【学位授予单位】：苏州大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R737.9
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