术前康复指导与术后康复指导对乳腺癌术后患肢功能恢复疗效的对比研究

Comparative study on the efficacy of affected limb functional recovery of breast cancerpatients with preoperative versus postoperative rehabilitation guidance

目的探讨术前康复指导与术后康复指导对乳腺癌患者术后患肢功能恢复的疗效。方法将126例实施乳腺癌改良根治术患者随机分为术前康复指导组（63例）和术后康复指导组（63例），术前康复指导组于术前3天开始进行康复训练指导，术后第1天开始患肢康复训练；术后康复指导组于术后第一天开始进行康复指导并患肢康复训练。术后2周、1个月、3个月分别观察两组患者上肢肌力恢复情况及关节活动度，并进行对比研究。结果术后2周、1个月、3个月两组肌力恢复至5级情况：术前康复指导组分别为S例、21例、36例，术后康复指导组分别为2例、12例、24例；术后2周、1个月、3个月两组患肢关节活动度恢复至正常范围情况：术前康复指导组分别为10例、38例、61例；术后康复指导组分别为3例、18例、53例。术前康复指导组患肢肌力及关节活动功能恢复明显优于术后康复指导组（p〈O．01）。结论术前康复指导更有利于乳腺癌术后患肢功能恢复，能够促进患肢术后关节功能早期恢复。

Objective To explore the efficacy of affected limb functional recovery of breast cancer patients with preoperative versus postoperative rehabilitation guidance, Methods 126 patients with modified radical mastectomy were averagely divided into two groups： preoperative and postoperative rehabilitation guidance groups, 63 patients for each group. Patients were indicated with rehabilitation guidance 3 days before surgery and had affected limb functional exercise I day after surgery in preoperative rehabilitation guidance group. The patients in the other group were indicated with rehabilitation guidance and training I day after surgery. The affected limb myodynamia and the motion ofjoint with patients in two groups 2 weeks, 1 month, 3 months after surgery were compared. Results There were 5, 21 and 36 patients whose limb myodynamia recovered to grade 5 in preoperative rehabilitation guidance group at 2 weeks, 1 month and 3 months after operation; while there were 2, 12, 24 cases with the same recovery in the other group. In preoperative rehabilitation guidance group, the motion of joint of 10, 38, 61 patients returned to normal situation at 2 weeks, 1 month and 3 months postoperatively; while 3, 18, 53 cases had the same recovery in the other group. The affected limb myodynamia and the motion of joint in preoperative rehabili- tation guidance group were significantly better than those in postoperative group（ P〈O.01 ）. Conclusions Preoperative rehabilitation guidance is more beneficial to limb functional recovery for the postoperative breast cancer patients and can improve function of joint after surgery with certain efficacy.