| 吴晓静,章小飞,杨琼.乳腺癌改良根治术后短暂性和持续性淋巴水肿发生的危险因素分析[J].浙江中西医结合杂志,2021,31(7): |
| 乳腺癌改良根治术后短暂性和持续性淋巴水肿发生的危险因素分析 |
| Analysis of risk factors for transient and persistent lymphedema after modified radical mastectomy for breast cancer |
| 投稿时间：2021-01-23 修订日期：2021-02-25 |
| DOI： |
| 中文关键词: 乳腺癌 改良根治术 短暂性淋巴水肿 持续性淋巴水肿 危险因素 |
| 英文关键词:breastcancer,modified radical mastectomy,transient lymphedema,persistent lymphedema,risk factors |
| 基金项目:浙江省医药卫生科技计划项目(2021ky049) |
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| 中文摘要: |
| 目的：明确乳腺癌改良根治术后短暂性和持续性淋巴水肿发生的危险因素。方法：回顾性分析了我中心2017年 1 月1日至 12 月1日收治的184例行乳腺癌改良根治手术患者的临床资料，记录术后淋巴水肿的发生情况，并采用logistic回归分析术后短暂性和持续性淋巴水肿发生的危险因素。结果：共有184例乳腺癌患者纳入研究，平均年龄50.39±11.18岁（23-74岁）。在术后随访过程中共有41例（22.28%）患者出现淋巴水肿，其中15例（8.15%）出现短暂性淋巴水肿，26例（14.13%）出现持续性淋巴水肿。单因素分析：年龄较大（≥50岁）、肥胖患者（BMI≥25）、清扫淋巴结数目较多（≥10）、术后接受放疗增加了短暂性和持续性淋巴水肿的发生风险，而淋巴结清扫范围较大（III组淋巴结）则增加了持续性淋巴水肿大发生风险， logistic多因素分析：肥胖患者（OR=3.363，P=0.042, 95%CI :1.044-10.836）和术后接受放疗（OR=5.803，P=0.015, 95%CI :1.401-24.034）是短暂性淋巴水肿发生的独立危险因素，而肥胖患者（OR=3.202，P=0.018, 95%CI :1.224-8.376）、淋巴结清扫范围较大（OR=3.033，P=0.031, 95%CI :1.110-8.288）和术后接受放疗（OR=4.238，P=0.025, 95%CI :1.200-14.968）是持续性淋巴水肿发生的独立危险因素。结论：对于乳腺癌患者，肥胖和术后接受放疗是短暂性和持续性淋巴水肿发生的独立危险因素，而淋巴结清扫范围过大则会影响持续性淋巴水肿的发生。 |
| 英文摘要: |
| Objective: To clarify the risk factors of transient and persistent lymphedema after modified radical mastectomy for breast cancer. Methods: The clinical data of 184 patients undergoing modified radical mastectomy for breast cancer admitted to our center from January 1 to December 1, 2017 were retrospectively analyzed, the incidence of postoperative lymphedema was recorded, and logistic regression analysis was used to analyze the postoperative Risk factors for transient and persistent lymphedema. Results: A total of 184 breast cancer patients were included in the study, with an average age of 50.39±11.18 years (23-74 years). During the postoperative follow-up, a total of 41 patients (22.28%) developed lymphedema, of which 15 patients (8.15%) developed transient lymphedema, and 26 patients (14.13%) developed persistent lymphedema. Univariate analysis: older age (≥50 years old), obese patients (BMI≥25), more lymph nodes dissected (≥10), postoperative radiotherapy increased the risk of transient and persistent lymphedema, while lymph nodes Large dissection area (group III lymph nodes) increases the risk of persistent lymphedema. Logistic multivariate analysis: obese patients (OR=3.363, P=0.042, 95%CI: 1.044-10.836) and postoperative radiotherapy ( OR=5.803, P=0.015, 95%CI: 1.401-24.034) is an independent risk factor for transient lymphedema, while obese patients (OR=3.202, P=0.018, 95%CI: 1.224-8.376) ), a large range of lymph node dissection (OR=3.033, P=0.031, 95%CI: 1.110-8.288) and postoperative radiotherapy (OR=4.238, P=0.025, 95%CI :1.200-14.968) are independent risk factors for persistent lymphedema. Conclusion: For breast cancer patients, obesity and postoperative radiotherapy are independent risk factors for transient and persistent lymphedema. Excessive lymph node dissection will affect the occurrence of persistent lymphedema. |
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