乳腺癌术后患者上肢周径与淋巴水肿相关症状关系的研究

The relationship between bilateral arm circumference and lymphedema symptoms in breast cancer survivors

目的了解乳腺癌术后患者双上肢周径及淋巴水肿相关症状发生情况,并分析两者之间的关系。方法对154例乳腺癌术后患者,采用上臂连续周径测量法确定患者双上肢周径;采用乳腺癌淋巴水肿症状体验指数评估患者淋巴水肿相关症状情况。结果19例(12.3%)双上肢周径差>2cm,99例(64.3%)双上肢周径差<1cm,36例(23.4%)双上肢周径差1~2cm。不同双上肢周径差患者淋巴水肿症状个数、症状严重程度、症状困扰及症状体验总分比较,差异有统计学意义(均P<0.01);双上肢周径差越大,症状个数、症状严重程度、症状困扰总分及症状体验总分显著增加(P<0.05,P<0.01)。腋窝淋巴结清扫术患者双上肢周径差大于前哨淋巴结活检术患者(P<0.01)。结论较大比例的乳腺癌术后患者存在淋巴水肿相关症状。通过症状评估可筛查出早期的隐匿水肿患者,需尽早为其提供干预措施预防或延缓淋巴水肿的发生。

Objective To figure out the relationship between bilateral arm circumference and lymphedema symptoms among breast cancer survivors.Methods Convenient sampling methods were used to recruit 154 participants who had undergone breast cancer surgery.Circumferential measurement of the upper limbs was used to confirm the differences of bilateral arm circumference;Breast Cancer and Lymphedema Symptom Experience Index（BCLE-SEI）was used to assess the symptoms experienced by breast cancer survivors.Results Among all 154 participants,19（12.3%）cases had maximum difference of bilateral arm circumference ≥2 cm（group 1）,while 99（64.3%）1 cm（group 2）,and 36（23.4%）between 1 and 2 cm（group 3）.Significant differences in the numbers of the symptoms,scores of symptom distress and six dimensions of symptom distress,and total scores of symptom experience were found among the 3 groups（P〈0.01 for all）.With the increase of maximum difference of bilateral arm circumferences,the numbers of the symptoms,scores of symptom occurrence and symptom distress,and total scores of symptom experience escalated significantly（P〈0.05,P〈0.01）.Patients receiving axillary lymph node dissection had greater maximum difference of bilateral arm circumferences than those receiving sentinel lymph node biopsy（P〈0.01）.Conclusion Lymphedema symptoms can exist in breast cancer survivors.Symptom assessment may contribute to figure out potential lymphedema and guide the intervention to prevent and delay the progression of lymphedema.