乳腺癌术后淋巴水肿CDT治疗效果分析

Therapeutic effects of CDT on postoperative lymphedema in patients with breast cancer

目的分析乳腺癌术后上肢淋巴水肿经综合消肿疗法(CDT)治疗的临床效果。方法选择2017年1月至2018年12月收治的乳腺癌术后上肢淋巴水肿患者97例,按随机数字表法分为观察组(n=50)和对照组(n=47)。对照组患者接受压力波治疗,观察组患者接受CDT治疗,治疗14 d后评估2组疼痛、患肢周径及患肢功能改善情况,并比较2组治疗后临床疗效。结果治疗前,2组VAS评分差异无统计学意义(P>0.05),治疗后,2组VAS评分较治疗前明显下降,且观察组VAS评分明显低于对照组(P<0.05)。治疗前,2组腋窝、肘横纹向上10 cm、肘横纹向下10 cm、腕横纹向上5 cm及手虎口等患肢周径差异无统计学意义(P>0.05);治疗后,2组患肢周径较治疗前明显缩小,且观察组患肢周径明显小于对照组(P<0.05)。治疗前,2组DASH评分差异无统计学意义(P>0.05);治疗后,2组DASH评分较治疗前明显下降,且观察组DASH评分明显低于对照组(P<0.05)。观察组治疗总有效率为96.00%明显高于对照组的48.94%(P<0.05)。结论对乳腺癌术后上肢淋巴水肿患肢实施CDT治疗,可明显减轻患者疼痛,促进其水肿症状消退、患肢功能改善,临床疗效确切,值得推广。

Objective To investigate the therapeutic effects of comprehensive detumescence therapy(CDT)on postoperative lymphedema in patients with breast cancer.Methods Ninety-seven patients with upper extremity lymphedema after breast cancer surgery who were treated in our hospital from January 2017 to December 2018 were enrolled in the study,who were randomly divided into observation group(n=50)and control group(n=47).The patients in control group received pressure wave therapy,however,the patients in observation group received CDT therapy.After 14-day treatment,the pain status,limb circumference,limb function improvement and clinical curative effects were observed and compared between the two groups.Results Before treatment,there were no significant differences in VAS scores between the two groups(P>0.05).After treatment,the VAS scores were significantly decreased in both groups,moreover,which in observation group were significantly lower than those in control group(P<0.05).Before,there were no significant differences in the circumferences of the affected limbs in armpits,elbows upward and downward 10cm,and upward 5cm of wrists transverse striation,the hand-Hukou between the two groups(P>0.05).After treatment,the circumferences of injuried limbs were significantly decreased in both groups,moreover,which in observation group were significantly smaller than those in control group(P<0.05).Before treatment,there were no significant differences in the DASH scores between the two groups(P>0.05).After treatment,the DASH scores were significantly decreased in both groups,moreover,which in observation group were significantly lower than those in control group(P<0.05).In addition the total effective rate in observation group(96.00%)was significantly higher than that(48.94%)in control group(P<0.05).Conclusion The application of CDT in treatment of upper limb lymphedema after breast cancer surgery can significantly reduce the pain of patients,relieve edema symptoms and improve the function of the affected limb,with definite curative effects,therefor,it is worth using widely in clinical practice.