乳腺癌腋窝淋巴结清扫术后上肢淋巴水肿的危险因素分析

研究背景：乳腺癌是女性常见的恶性肿瘤之一，同时也是治愈率最高的癌症，文献报道早期乳腺癌术后5年生存率达85．16％。上肢淋巴水肿是腋窝淋巴结清扫术后常见并发症，术后10—35％患者出现上肢水肿，就上肢淋巴水肿的风险因素，国内外做了许多研究，但结果不一，分歧较大。方法：抽取60例腋窝淋巴结清扫术后患者，调查统计可能与腋窝淋巴结清扫术后上肢淋巴水肿相关的8个因素（变量）：年龄、临床分期、是否放疗、是否出现延迟愈合／感染／积液等术后其它并发症、术后上肢功能锻炼、是否是优势侧，平时是否参加体育锻炼，是否有高血压等合并症。数据采用SPSS13．0分析软件以logistic回归方法进行分析。结果：四项关联因素分别为：1、是否放疗（OR=8．966）2、延迟愈合／感染／积液等其它术后并发症（0R=8．493）3、术后上肢功能锻炼（OR=0．194）4、高血压（0R=5．609）。结论：放疗、其它术后并发症、高血压为腋窝淋巴结清扫术后上肢淋巴水肿的风险因素，而术后上肢功能锻炼为术后水肿的保护因素。

Analysis of the Risk Factors of the Arm Lymphedema Following Axillary Lymph Node Dissection for Breast Cancer

Objective： Breast cancer is one of the most common malignant tumor of women all around the world. The survival rate of breast tumor tops all the female malignant tumors, and the five-year survival rate can be 85.16%. However, arm lymphedema following axillary lymph node dissection （ALND） for breast cancer is a common complication, and happens to 10-35% of the postoperative patients. As to the risk factors of lymphedema following ALND, different researches have different results. Method： 60 unilateral breast cancer patients who received ALND were surveyed mainly about eight factors that may induce arm lymphedema following ALND： age, clinical stage of tumor, radiotherapy, other complication （late healed/infection/effusion of the wound）, postoperative functional exercise, dominant hand, physical exercise and hypertension, and the statistics were analyzed with logistic regression （SPSS v13.0）, Results： Four factors are related to ann lymphedema following ALND： 1. radiotherapy（OR=8.966 ）; 2.other postoperative complication（OR=8.493 ）;3. hypertension （OR=5.609） ;4.postoperative functional exercise （OR=0.194）. Conclusion： Among these four factors, radiotherapy ,other postoperative complications and hypertension are risk factors, and postoperative functional exercise is a protective factor.