乳腺癌根治术后早期应用微波热疗联合标准康复锻炼在防治患肢水肿中的临床研究

Clinical Study on the Early Application of Microwave Hyperthermia Combined with Standard Rehabilitation Exercises in the Prevention and Treatment of Limb Edema After Radical Mastectomy

目的探索乳腺癌根治术后采用患肢标准康复锻炼联合早期应用915 MHz微波局部热疗,对防治患肢淋巴水肿的临床疗效。方法本研究中,选择2021年6月至2023年3月期间在南昌市人民医院接受乳腺恶性肿瘤根治术的200例患者作为研究对象,剔除4例因疾病进展退出的患者后,随机将剩余的196例患者分为观察组和对照组,每组各98例。对照组患者在乳腺恶性肿瘤根治术后仅接受标准的患肢康复锻炼,而观察组患者在接受标准康复锻炼的基础上,联合早期应用频率为915 MHz的微波局部热疗。微波热疗作用于患肢腋窝、锁骨三角区、颈部区域,输出功率为80~100 W,局部测温在39~42℃,60 min/次,3次/周,10次为1个疗程,共治疗2个疗程。两组患者分别于术后6个月、12个月、18个月回访观察患肢淋巴水肿程度。比较两组患者在干预前后患肢淋巴水肿的SAS和SDS评分、视觉模拟评分、手术相关不良事件发生率及护理服务满意度。结果治疗后,观察组在上肢淋巴水肿分级方面相比对照组有所下降,达到一个等级及以上的改善效果更为明显,具有统计学意义(P<0.05)。结论乳腺癌根治术后,患肢标准康复锻炼联合早期微波局部热疗相比单独进行标准康复锻炼,在减轻术后患肢淋巴水肿及改善临床症状方面具有更佳的临床效果,为乳腺癌手术后的康复治疗提供了一种新的有效方法。

Objective To explore the clinical efficacy of standard rehabilitation exercise of affected limbs combined with early application of 915 MHz microwave local hyperthermia after breast cancer radical surgery in the prevention and treatment of lymphedema of affected limbs.Methods In this research,a total of 200 patients who underwent radical mastectomy for malignant breast tumors at our hospital between June 2021 and March 2023 were chosen as the study participants.After excluding 4 patients due to disease progression,196 patients were randomly assigned to either the observation group or the control group,each consisting of 98 patients.The control group received standard rehabilitation exercises for the affected limb post-mastectomy,while the observation group received the same exercises along with early application of microwave local hyperthermia at 915 MHz frequency.The microwave hyperthermia targeted the armpit,clavicle triangle,and neck area of the affected limb,with an output power of 80-100W and local temperature maintained at 39-42℃.Each session lasted 60 minutes,conducted 3 times a week,and a course of treatment comprised 10 sessions.Two courses of treatment were administered.Follow-up assessments were conducted at 6,12,and 18 months post-surgery to evaluate lymphedema severity in the affected limbs.Comparison of SAS and SDS scores,visual analogue scores,incidence of surgery-related adverse events,and nursing service satisfaction related to limb lymphedema were made between the two groups before and after the intervention.Results After treatment,the observation group showed a significant decrease in the grading of upper limb lymphedema compared to the control group,and the improvement effect was more significant when reaching one or more grades,with statistical significance(P<0.05).Conclusions After radical surgery for breast cancer,the standard rehabilitation exercise of the affected limb combined with early microwave local hyperthermia has better clinical effect than the standard rehabilitation exercise alone in reducing the lymphedema of the affected limb and improving the clinical symptoms,which provides a new effective method for the rehabilitation treatment of breast cancer after surgery.