乳腺癌术后上肢淋巴水肿原因及防治的探讨.docVIP

乳腺癌术后上肢淋巴水肿原因及防治的探讨 　　【摘要】 目的 探索乳腺癌根治术后上肢淋巴水肿的原因及防治。方法 对420例乳腺癌术后105例上肢淋巴水肿进行回顾性分析。结果 420例乳癌根治术患者中，160例行Halsted根治术，发生患侧上肢淋巴水肿54例,发生率33．75%(54/160)，其中Ⅰ级27例、Ⅱ级18例、Ⅲ级9例；260例行Patey改良根治术，51例发生淋巴上肢水肿，发生率为19．61%(51/260)其中Ⅰ级27例、Ⅱ级15例、Ⅲ级9例。根治组术后放疗127例，发生上肢淋巴水肿47例。改良根治组放疗112例，发生上肢淋巴水肿37例。结论 乳腺癌术后上肢淋巴水肿与手术方式和术后放疗有关。? 　　【关键词】乳腺癌；并发症；淋巴水肿 　　?? 　　Cause and treatment evaluation on upper limb lymphedema post mastectomy of breastcancer 　　 　　LIU De-chun，LUO Xiang.Deparment of General Surgery Ⅱof the First Affiniated Hospital,Science and Technology of Henan University,Luoyang 471003， China 　　? 　　【Abstract】 Objective TO explore the cause and therapy on upperlimb lymphedema post mastectomy of breast cancer.Methods 　　To give an analysis to 105 cases of upper limb lymphedema in 420 cases of experienced breast cancer mastectomy retrospectedly.Results upper limb lymphedema was found in 105 of420 cases,which divided into halsted mastectomy groups(160)and patgy mastectomy groups(260).In halsted groups,lymphedema 54 in 160,the rate is 33．75%,Ⅰgrade 27,Ⅱgrade 18,Ⅲ grade 9;in patgy groups,lymphyedema 51 in 260,the rate is 19．61%,Ⅰgrade 27,Ⅱgrade15,Ⅲ grade9;127 cases were employed radiotherapy after operation which of 47 with lymphyedema in mastectomy groups,in patgy groups 112 cases to radiotherapy and 37 with lymphedema.Conclusion To the breast cancer patients who experienced mastectomy and with upper limb lymphedema,the way of operation and radiotherapy were main keys leading to lymphedema,there is no effective therapy on lymphedema treatment.? 　　【Key words】Breast cancer；Iymphedema;Complication 　　? 　　乳腺癌术后常有上肢不同程度的肿胀及伴随感觉异常，在数月甚或数年后可出现淋巴水肿，现对近二十余年乳癌术后患者收集情况对术后上肢淋巴水肿的原因及治疗报告如下。? 　　 　　1 临床资料? 　　 　　1．1 一般资料 1986-2006年间行乳腺癌根治术420例,患者均为女性,年龄25~76岁,平均51岁。共105例发生上肢淋巴水肿，其中160例行Halsted根治术，发生患侧上肢淋巴水肿54例,发生率33．75%(54/160)，Ⅰ级27例、Ⅱ级48例、Ⅲ级9例；260例行Patey改良根治术，51例发生上肢淋巴水肿，发生率为19．61%(51/260)，其中Ⅰ级27例、Ⅱ级15例、Ⅲ级9例。根治组术后放疗127例，发生上肢淋巴水肿47例。改良根治组放疗112例，发生上肢淋巴水肿47例。水肿按淋巴学国际协会标准分类。? 　　1．2 淋巴水肿分类 淋巴上肢水肿