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[目的]探讨乳腺癌术后上肢淋巴水肿的危险因素。[方法]回顾性分析2009年7月到2015年2月早期乳腺癌女性患者250例,所有患者都给予乳腺癌根治性手术,术中均进行了前哨淋巴结活检,查阅所有患者的病史资料,记录术后上肢淋巴水肿发生情况,对疼痛、上臂与前臂状况进行记录。[结果]250例患者术后发生上肢淋巴水肿30例,发生率为12.0%。Logistic分析结果显示放疗方式、切口延迟愈合、缺乏上肢功能锻炼和合并糖尿病是导致乳腺癌术后上肢淋巴水肿发生的主要影响因素(P<0.05)。30例上肢淋巴水肿患者的术后3个月疼痛评分为5.33±0.32分,明显高于术前的1.87±0.45分(P<0.05)。同时术后3个月的上臂差值与前臂差值分别为0.70±0.30cm和0.98±0.64cm,与术后1个月的1.19±0.40cm和0.73±0.72cm对比都有统计学差异(P<0.05)。[结论]乳腺癌术后上肢淋巴水肿的发生率比较高,可导致患者疼痛加剧,上臂与前臂状况异常,放疗、切口延迟愈合、缺乏上肢功能锻炼和合并糖尿病为主要的危险因素。
[Objective] To explore the risk factors of postoperative upper limb lymphedema in breast cancer. [Methods] A retrospective analysis of 250 women with early breast cancer from July 2009 to February 2015 was performed. All patients underwent radical surgery for breast cancer. All patients underwent SLN biopsy during the operation. All patients’ medical records were obtained and recorded Postoperative upper limb lymphedema occurred, the pain, upper arm and forearm status were recorded. [Result] Thirty cases of upper extremity lymphedema occurred in 250 patients, the incidence was 12.0%. Logistic analysis showed that radiation therapy, delayed incision healing, lack of upper limbs exercise and diabetes mellitus were the main influencing factors of postoperative upper limb lymphedema (P <0.05). The pain score at 3 months after operation in 30 patients with upper extremity lymphedema was 5.33 ± 0.32, which was significantly higher than that of preoperative 1.87 ± 0.45 (P <0.05). At the same time, the difference between the upper arm and the forearm at 3 months after operation was 0.70 ± 0.30 cm and 0.98 ± 0.64 cm respectively, which was significantly different from 1.19 ± 0.40 cm and 0.73 ± 0.72 cm at 1 month after operation (P <0.05). [Conclusion] The incidence of postoperative upper extremity lymphedema in breast cancer patients is relatively high, which may lead to the exacerbation of pain, the abnormality of the upper arm and forearm, the delayed healing of radiotherapy and incision, the lack of upper limbs exercise and diabetes mellitus as the main risk factors.