皮瓣辅助胸壁缝合贴紧减小腔隙引流、绷带加压在乳腺癌术后上肢淋巴水肿患者中的应用

Flap-Assisted Chest Wall Suture Tightening to Reduce Luminal Drainage and Bandage Compression in Patients with Upper Extremity Lymphedema After Breast Cancer Surgery

目的探讨皮瓣辅助胸壁缝合贴紧减小腔隙引流、绷带加压治疗乳腺癌术后上肢淋巴水肿患者的临床效果。方法选取商丘市第四人民医院2019年2月至2021年2月收治的94例乳腺癌术后上肢淋巴水肿患者为研究对象,按随机数字表法将患者分为传统组和研究组,每组47例。传统组接受综合消肿法治疗,研究组于传统组基础上接受皮瓣与胸壁贴紧缝合减小腔隙引流、绷带加压治疗。对比两组临床疗效、满意度、治疗前后上肢水肿情况、上肢功能、肩关节功能、疼痛程度、生活质量。结果研究组总有效率(93.48%)较传统组(73.33%)高(P<0.05)。治疗后两组上肢水肿情况改善,且研究组改善幅度优于传统组(P<0.05)。治疗后,两组Fugl-Meyer评估量表(FMA)、Constant-Murley评估量表(Constant-Murley)、乳腺癌患者生命质量量表(FACT-B)升高,视觉模拟量表(VAS)评分降低,且研究组FMA、Constant-Murley、FACT-B评分高于传统组,VAS评分低于传统组(P<0.05)。研究组满意度(93.48%)较传统组(75.56%)高(P<0.05)。结论对乳腺癌术后上肢淋巴水肿患者于综合消肿治疗基础上给予皮瓣辅助胸壁缝合贴紧减小腔隙引流、绷带加压效果显著,能减轻上肢水肿程度,缓解患者疼痛,有助于上肢功能恢复,改善生活质量,提高满意度。

Objective To investigate the clinical efficacy of flap-assisted chest wall suture apposition to reduce luminal drainage and bandage compression in the treatment of patients with upper limb lymphedema after breast cancer surgery.Methods A total of 94 patients with upper limb lymphedema after breast cancer surgery admitted to the Fourth People’s Hospital of Shangqiu from February 2019 to February 2021 were selected for the study,and the patients were divided into traditional group and study group by random number table method,with 47 cases in each group.The traditional group was treated with comprehensive swelling reduction method,while the study group was treated with skin flap and chest wall tight suture to reduce luminal drainage and bandage compression on the basis of the traditional group.The clinical efficacy,satisfaction,upper limb edema before and after treatment,upper limb function,shoulder function,pain level,and quality of life were compared between the two groups.Results The total effective rate of study group(93.48%)was higher than that of traditional group(73.33%)(P<0.05).After treatment,the upper limb edema of the two groups was improved,and the improvement of the study group was better than the traditional group(P<0.05).After treatment,Fugl-Meyer assessment scale(FMA),Constant-Murley assessment scale(Constant-Murley),functional assessment of cancer therapy-breast(FACT-B)increased,visual analogue scale(VAS)score decreased,and FMA,Constant-Murley and Fact-B score in the study group were higher than those in the traditional group,and VAS score was lower than that in the traditional group(P<0.05).The satisfaction of study group(93.48%)was higher than that of traditional group(75.56%)(P<0.05).Conclusion In postoperative breast cancer patients with upper limb lymphedema,flap-assisted chest wall suture tightening to reduce luminal drainage and bandage compression is effective in reducing the degree of upper limb edema,relieving patients’pain,helping upper limb function recovery,improving the quality of life and increasing satisfaction based on comprehensive swelling treatment.