早期阶段性功能锻炼对乳腺癌改良根治术后患者上肢功能恢复的影响

Effect of early stage functional exercise on upper limb function recovery in patients with breast cancer after modified radical mastectomy

目的分析早期阶段性功能锻炼对乳腺癌改良根治术后患者上肢功能恢复的影响。方法142例乳腺癌改良根治术后患者,随机分为研究组与对照组,每组71例。研究组患者采取早期阶段性功能锻炼,对照组患者采取普通常规功能锻炼。对比两组患者锻炼后15 d、15周的肩关节活动度(肩关节前屈、后伸、内收、外展角度)及术后并发症(上肢水肿、皮下积液、皮瓣坏死)发生情况。结果锻炼后15 d,研究组患者的肩关节前屈、后伸、内收、外展角度均大于对照组,差异具有统计学意义(P<0.05)。锻炼后15周,研究组患者的肩关节前屈、后伸、内收、外展角度分别为(178.39±4.90)、(55.34±3.80)、(83.48±4.60)、(175.81±12.00)°,均大于对照组患者的(152.31±3.70)、(45.33±3.40)、(67.03±4.20)、(155.98±10.20)°,差异具有统计学意义(P<0.05)。研究组患者术后上肢水肿发生率8.45%明显低于对照组患者的39.44%,差异具有统计学意义(P<0.05)。结论对乳腺癌改良根治术后患者采取早期阶段性功能锻炼,能够有效恢复患者的上肢功能,减少术后并发症发生情况,值得临床推广使用。

Objective To analyze the effect of early stage functional exercise on upper limb function recovery in patients with breast cancer after modified radical mastectomy.Methods A total of 142 cases of breast cancer patients after modified radical mastectomy were randomly divided into research group and control group,with 71 cases in each group.Patients in the research group took early-stage functional exercise,and patients in the control group took ordinary conventional functional exercise.Both groups were compared in terms of range of motion of shoulder joint(angle of shoulder flexion,extension,adduction,and abduction)and postoperative complications(upper limb edema,subcutaneous effusion,skin flap necrosis)at 15 d and 15 weeks after exercise.Results At 15 d after exercise,the angle of shoulder flexion,extension,adduction,and abduction of the research group were greater than those of the control group,and the differences were statistically significant(P<0.05).At 15 weeks after exercise,the angle of shoulder flexion,extension,adduction,and abduction of the research group were(178.39±4.90),(55.34±3.80),(83.48±4.60),and(175.81±12.00)°,which were greater than(152.31±3.70),(45.33±3.40),(67.03±4.20),and(155.98±10.20)°of the control group,and the differences were statistically significant(P<0.05).The incidence of postoperative upper limb edema in the research group was 8.45%,which was significantly lower than 39.44%in the control group,and the difference was statistically significant(P<0.05).Conclusion Early-stage functional exercise for patients with breast cancer after modified radical mastectomy can effectively restore upper limb function and reduce postoperative complications,which is worthy of clinical promotion and application.