乳腺癌改良根治术后患肢功能锻炼时机的研究

The study of timing on functional exercise of the affected limb after modified radical mastectomy of breast cancer

目的探讨乳腺癌改良根治术后不同的锻炼时机对上肢肩关节活动度、淋巴水肿发生率的影响效果。方法选择2016年4—10月我院行乳腺癌改良根治术后行放射治疗的患者215例作为研究对象,根据患者术后开始锻炼时间将患者分为3组:术后早期锻炼组(术后3 d内开始锻炼);术后中期锻炼组(术后3~14 d开始锻炼);术后晚期锻炼组(术后14 d后开始锻炼)。比较3组不同的锻炼时机对上肢肩关节活动度和淋巴水肿发生率的影响。结果3组患者患侧上肢上举高度比较差异无统计学意义(P>0.05),3组患者患侧上肢上举角度、后伸高度比较差异有统计学意义(P<0.05);215例患者中有11例(5.12%)发生轻度淋巴水肿,3组患者淋巴水肿发生率比较差异无统计学意义(P>0.05)。结论乳腺癌改良根治术后3 d内开始锻炼后伸高度恢复较好,术后14 d内开始锻炼上举角度恢复较好。不同的锻炼时机对术后淋巴水肿发生率没有影响。

Objective To investigate the influencing effect of different exercise timings on mobility of shoulder joint of upper limb and incidence of lymphedema after modified radical mastectomy of breast cancer.Methods We selected 215 cases of patients who underwent radiotherapy after modified radical mastectomy for breast cancer in our hospital from April to October 2016 as the study objects.The patients were divided into 3 groups according to the time of starting exercise after surgery.Early-stage exercise group(start exercise within 3 days after surgery);mid-stage exercise group(start exercise at 3-14 days after surgery);late stage exercise group(start exercise at 14 days after surgery).The mobility of shoulder joint of upper limb and incidence of lymphedema in different exercise timings were compared between the three groups.Results There was no significant difference in the height of the upper limb lift on the affected side between the three groups(P>0.05).There was a significant difference in the angle of upper limb lift and the extension height on the affected side among the three groups(P<0.05).Mild lymphedema occurred in 11 cases(5.12%)of the 215 patients,there was no significant difference in incidence of lymphedema between the three groups(P>0.05).Conclusion The recovery of the extension height was better within 3 days after the modified radical mastectomy of breast cancer,and the recovery of the lift angle was better within 14 days after the operation.The different exercise timings had no effect on the incidence of postoperative lymphedema.