乳腺癌手术方式与上肢淋巴水肿的相关研究

Relationship study between the way of mastectomy and upper limb lymphedema

目的探索乳腺癌根治术后上肢淋巴水肿的原因及防治。方法对340例乳腺癌术后发生的86例上肢淋巴水肿进行回顾性分析。结果340例乳腺癌根治术患者中,179例行Halsted根治术,发生患侧上肢淋巴水肿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例发生上肢淋巴水肿,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。

Obsject To explore the cause and therapy on upperlimh lymphedema post mastectomy of breast cancer.Methods to give an analysis to 86 cases of upper limb lymphedema in 340 cases of experienced breast cancer mastectomy retrospectedly. Results Upper limb lymphedema was found in 86 of 340 cases, which divided into Halsted mastectomy groups （179） and patgy mastectomy groups （161）.In Halsted groups,lymphedema 56 in 179,the rate is 31.28%, Ⅰ grade 28, Ⅱ grade 19, Ⅲ grade 9; in patgy groups,lymphyedema 30 in 161 ,the rate is 18.63%, Ⅰ grade 15, Ⅱ gradel 1, Ⅲ grade4; 121 cases were employed radiotherapy after operation which of 37 with lymphyedema in mastectomy groups, in patgy groups 59 cases to radiotherapy and 17 with lymphedema. Conclusion The way of operation and radiotherapy were main key reasons to lymphedema, there is no effective therapy on lymphedema treatment.