彩超对乳腺癌术后腋窝血管血流动力学改变的临床观察

目的：探讨乳腺癌术后患者腋窝血管的血流动力学状态是否存在改变及应用彩色多普勒超声检查的可行性。方法：搜集我院69例右乳腺癌改良根治术后复查患者，用彩色多普勒超声观察其腋动脉、静脉的内径（internal diameter，ID）、收缩期最大流速（peak systolic velocity，PSV）、舒张末期流速（end diastolic velocity，EDV）、平均流速（time averge velocity，TAV）、搏动指数（pulsatility index，PI）及阻力指数（resistivity index，Ⅲ），与正常组作对照，进行统计学处理。结果：术后患肢腋静脉的PSV、EDV、TAV值较正常对照组减慢约24．0％，36．7％，34．9％；患肢腋动脉收缩期、舒张期、平均流速分别降低23．7％，47．9％，28．3％，差异均有统计学意义（P〈0．05）。术后血管工ID、PI、RI未见明显改变。术后有上肢水肿者较无症状者腋静脉PSV、EDV、TAMAX值明显下降（P〈0．05），而腋动脉各参数无明显改变（P〉0．05）。结论：乳腺癌改良根治术对腋窝血管的处理一定程度影响患侧上肢的血供。彩色多普勒超声检查腋窝血管血流动力学是一种可靠的方法。

Clinical observations on hemodynamic changes of axillary vessel after breast cancer surgery by color Doppler ultrasound

Objective： To investigate file hemodynamic changes of axiUary vessel after breast cancer surgery and the feasibility of application of color Doppler ultrasound. Methods：Collect 69 reexamination cases of modified radical masteetomy on right breast cancer, and use color Doppler ultrasound to observe the internal diameter （ID）, peak systolic velocity （PSV）, end diastolic velocity （EDV）, time averge velocity （TAV）, pulsatility index （PI）, and resistivity index （RI） of both axillary artery and vein. We compare the results to the normal group and conduct statistical analysis. Results： Comparing to the normal group, the PSV, EDV, and TAV readings of axillary vein in affected limb are slower by 24.0%, 36.7%, and 34.9%, respectively, while those values of axillary artery are slower by 23.7%, 47.9%, and 28.3%, respectively. All the results are statistically significant with P 〈 0.05. At the same time, no obvious change is observed in ID, PI, and RI readings. Comparing asymptomatie patients with the patients who has upper extremity edema after surgery, the latter＇ s PSV, EDV, and TAV readings of axillary vein in affected limb are slower （ P 〈 0.05）, but no obvious change is observed in axillary artery＇s readings（ P 〉 0.05）. Conclusion：To some extent, the treatment on axillary vessels during modified radical masteetomy on breast cancer has an effect on blood supply of affected upper limb. Using color Doppler ultrasound to evaluate the hemodynamies of axillary vessel is a reliable approach.