乳腺癌术后患侧上肢淋巴水肿原因及防治探讨

Cause and treatment of upper limb lymphedema after mastectomy of breast cancer

目的探索乳腺癌根治术后患侧上肢淋巴水肿的原因及防治。方法对340例乳腺癌术后86例上肢淋巴水肿进行回顾性分析。结果340例乳癌根治术患者中,179例行Halsted根治术,发生患侧上肢淋巴水肿病例56例,发生率31.28%(56/179),其中Ⅰ级28例、Ⅱ级19例、Ⅲ级9例;161例行Patey改良根治术,30例发生淋巴上肢水肿,发生率为18.63%(30/161),其中Ⅰ级15例、Ⅱ级11例、Ⅲ级4例。根治组术后放疗121例,发生上肢淋巴水肿37例。改良根治组放疗59例,发生上肢淋巴水肿17例。结论乳腺癌术后上肢淋巴水肿主要与手术方式和术后放疗有关,术后上肢淋巴水肿重在预防和早期治疗。

Objective：To explore the cause and treatment on upper limb lymphedema after mastectomy of breast cancer. Methods： To analyze 86 cases of upper limb lymphedema in 340 cases who experienced breast cancer mastectomy retrospectively. Results： Upper limb lymphedema was found in 86 of 340 cases, which divided into Halsted mastectomy groups（179） and patgy mastectomy group （161）. In Halsted groups ,lymphedema developed in 56 of 179 ,the rate was 31.28% , Ⅰ grade 28, Ⅱ grade 19, Ⅲ grade 9 ; Ⅳ cases were employed radiotherapy after operation which of 37 with lymphyedema in mastectomy groups,in patgy groups ,lymphyedema developed in 30 of 161 ,the rate was 18.63%, Ⅰ grade 15, Ⅱ grade Ⅱ, Ⅲ grade 4; 59 cases were treated with radiotherapy and 17 developed lymphedema. Conclusion： To the breast cancer patients who experienced mastectomy and with upper limb lymphedema , the way of operation and radiotherapy axe main factor wlieh leading to lymphedema, there is no effective therapy on lymphedema.