摘要
目的分析乳腺癌改良根治术后并发上肢淋巴水肿的危险因素。方法观察性研究。对2020年5月至2022年5月在焦作市第二人民医院收集的病例展开研究,将严格按照选取标准筛选后的72例行乳腺癌改良根治术治疗的患者作为研究对象。统计患者临床资料,分析乳腺癌改良根治术后上肢淋巴水肿发生率;对比发生和未发生上肢淋巴水肿患者临床资料的差异,分析危险因素。结果乳腺癌改良根治术后上肢淋巴水肿发生率为41.67%(30/72)。30例上肢淋巴水肿患者中轻度15例(50.00%),中度11例(36.67%),重度4例(13.33%)。两组年龄、体质指数、临床分期、是否放疗、腋窝淋巴结清扫范围水平、有无术后并发症、是否淋巴转移、术后锻炼依从性比较差异有统计学意义(P<0.05)。logistic回归分析结果显示,年龄≥60岁(β=1.191,OR=3.290,95%CI 1.267~8.543)、体质指数≥25 kg/m^(2)(β=1.445,OR=4.241,95%CI 2.587~6.954)、临床分期Ⅲ期(β=1.153,OR=3.168,95%CI 1.521~6.598)、放疗(β=0.978,OR=2.659,95%CI 1.774~3.985)、腋窝淋巴结清扫范围Ⅲ水平(β=1.554,OR=4.731,95%CI 2.187~10.234)、术后并发症(β=1.644,OR=0.319,95%CI 2.597~10.315)、淋巴转移(β=1.231,OR=3.426,95%CI 1.369~8.574)、术后锻炼依从性差(β=1.594,OR=4.926,95%CI 2.366~10.254)是乳腺癌改良根治术后并发上肢淋巴水肿的危险因素(P<0.05)。结论乳腺癌改良根治术后并发上肢淋巴水肿的风险较高,临床应根据上述危险因素实施针对性防控措施,降低其发生风险。
Objective To analyze the risk factors of upper limb lymphedema after modified radical mastectomy.Methods This study was an observational study conducted in Jiaozuo Second People’s Hospital from May 2020 to May 2022.A total of 72 patients who underwent radical mastectomy were selected as the research objects after strict screening according to the inclusion and exclusion criteria.The clinical data of the selected patients were collected,and the incidence of upper limb lymphedema after modified radical mastectomy was analyzed.The clinical data of patients with and without upper limb lymphedema were compared,and the risk factors were analyzed.Results The incidence of upper limb lymphedema after modified radical mastectomy was 41.67%(30/72).Among the 30 cases of upper limb lymphedema,15 cases(50.00%)were mild,11 cases(36.67%)were moderate,and 4 cases(13.33%)were severe.There were significant differences in age,body mass index,clinical stage,radiotherapy,axillary lymph node dissection range,postoperative complications,lymph metastasis and postoperative exercise compliance between the two groups(P<0.05).Results of logistic regression analysis showed that age≥60 years(β=1.191,OR=3.290,95%CI:1.267-8.543),body mass index≥25 kg/m^(2)(β=1.445,OR=4.241,95%CI:2.587-6.954),clinical stageⅢ(β=1.153,OR=3.168,95%CI:1.521-6.598),radiotherapy(β=0.978,OR=2.659,95%CI:1.774-3.985),axillary lymph node dissection rangeⅢlevel(β=1.554,OR=4.731,95%CI:2.187-10.234),postoperative complications(β=1.644,OR=0.319,95%CI:2.597-10.315),lymph metastasis(β=1.231,OR=3.426,95%CI:1.369-8.574),and poor postoperative exercise compliance(β=1.594,OR=4.926,95%CI:2.366-10.254)were risk factors for upper limb lymphedema after modified radical mastectomy(P<0.05).Conclusions The risk of upper limb lymphedema after modified radical mastectomy is relatively high,and clinical measures should be taken according to the above risk factors to reduce the risk of occurrence of the disease.
作者
李瑾
赵苗苗
毋春玲
Li Jin;Zhao Miaomiao;Wu Chunling(Department of Thyroid and Breast Surgery,Jiaozuo Second People’s Hospital,Jiaozuo 454000,China)
出处
《中国实用医刊》
2024年第7期38-40,共3页
Chinese Journal of Practical Medicine
关键词
乳腺癌
乳腺癌改良根治术
上肢淋巴水肿
危险因素
Breast neoplasms
Modified radical mastectomy
Upper limb lymphedema
Risk factors
