乳腺癌腋窝淋巴结清扫术中上肢淋巴结选择保留对淋巴水肿发生率的影响

Effect of upper limb lymph node selection on the incidence of lymphedema in breast cancer patients undergoing axillary lymph node dissection

目的 :探讨腋窝淋巴结清扫术中上肢淋巴结选择性保留对乳腺癌患者淋巴结水肿发生率的影响。方法 :回顾性分析2014年8月～2016年4月在我院接受手术的乳腺癌患者的临床资料,根据其手术方式分为对照组和观察组,对照组给予传统手术治疗,观察组在术中选择性保留淋巴结。观察两组患者手术一般情况、淋巴结转移和水肿发生率,比较两组患者手术前后肿瘤标志物和生活质量的差异。结果 :观察组术中出血量较对照组少,术后住院时间较对照组短,两组患者手术时间无明显差别;观察组患者术后淋巴结水肿发生率较对照组低,两组患者术后1年淋巴结转移发生率无明显差别;两组患者手术前肿瘤标志物水平无差别,手术后1年,两组患者的肿瘤标志物水平均较手术前降低,而两组间比较无差别;两组患者手术前生活质量无差别,手术后1年,观察组生活质量得分明显高于对照组。结论 :腋窝淋巴结清扫术中选择性保留上肢淋巴结能有效地降低术后淋巴结水肿发生率,提高患者生活质量,具有良好的应用价值。

Objective To investigate the effect of upper limb lymph node reservation on axillary lymph node edema in patients with axillary lymph node dissection.Methods The clinical data of patients with breast cancer who underwent surgery in our hospital from August 2014 to April 2016 were retrospectively analyzed.The patients were divided into control group and observation group according to the operation mode,The control group was treated with traditional surgery,while the observation group was selected to retain the lymph nodes.The two groups of patients with general surgery,lymph node metastasis and edema incidence were observed,and the differences of tumor markers and quality of life between the two groups were compared before and after operation.Results Compared with the control group,the amount of bleeding in the observation group was shorter than that in the control group.There was no significant difference in the operation time between the two groups;The incidence of postoperative lymph node edema was lower in the observation group than in the control group,and there was no significant difference between the two groups in the incidence of lymph node metastasis in the 1 groups;There was no difference in the level of tumor markers before and after operation in the two groups.The tumor markers in the two groups were significantly lower than those before operation,and there was no difference between the two groups after the operation for the last 1 years;There was no difference in quality of life between the two groups before operation,and the quality of life score of the observation group was significantly higher than that of the control group after operation for 1 years.Conclusion Lymph node dissection can effectively reduce the incidence of postoperative lymph node edema and improve the quality of life of patients with axillary lymph node dissection.