乳腺癌根治术病人术后腋网综合征的logistic影响因素分析

    Logistic analysis of influencing factors of axillary reticulum syndrome in patients undergoing radical mastectomy

    • 摘要:
      目的: 应用logistic回归分析乳腺癌根治术后病人腋网综合征(AWS)发生的危险因素,为临床制定针对性防治措施提供更多参考依据。
      方法: 选取200例乳腺癌病人,分析乳腺癌根治术后AWS的影响因素。
      结果: 根治术后病人AWS发生率为29%。logistic回归分析显示,MBI < 24 kg/m2、腋窝淋巴结清扫术(ALND)、淋巴结清扫数≥15枚、淋巴结转移、放疗为乳腺癌根治术后AWS发生的独立危险因素(P < 0.05~P < 0.01),患侧肢体术后早期行康复锻炼、患侧术后行规范肩部运动则为保护因素(P < 0.01)。
      结论: 临床医生应严控ALND手术指征,减少行ALND率;可在术前行辅助化疗以抑制肿瘤,术后密切关注淋巴液回流情况,预防淋巴液回流阻碍以及炎症反应的发生,并重视术后早期功能锻炼,降低术后AWS发生风险。

       

      Abstract:
      Objective To analyze the risk factors for the occurrence of axillary web syndrome (AWS) in patients after radical mastectomy for breast cancer by logistic regression, and provide more references for the clinical development of targeted prevention and treatment measures.
      Methods A total of 200 cases of patients with breast cancer were selected to analyze the influencing factors of AWS after radical mastectomy.
      Results The incidence of AWS in patients after radical mastectomy was 29%. Logistic regression analysis showed that MBI < 24 kg/m2, axillary lymph node dissection (ALND), number of lymph nodes dissected ≥15, lymph node metastasis, and radiotherapy were the independent risk factors for the occurrence of postoperative AWS in patients undergoing radical mastectomy for breast cancer, while early postoperative rehabilitation of the affected limb and standardized shoulder exercise on the affected limb after surgery were the protective factors.
      Conclusion Clinicians should strictly control the indications for ALND surgery to reduce the rate of performing ALND. Adjuvant chemotherapy can be performed preoperatively to inhibit the tumor, and postoperative lymphatic fluid reflux should be closely monitored to prevent obstruction of lymphatic fluid reflux as well as inflammatory reactions, and attention should be paid to early postoperative functional exercises to reduce the risk of postoperative AWS.

       

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