保留上肢淋巴结的乳腺癌腋窝淋巴结清扫术对预防上肢淋巴水肿的影响

目的：研究保留上肢淋巴结的乳腺癌腋窝淋巴结清扫术对预防上肢淋巴水肿的影响。方法方便选择2014年1月—2015年6月期间该院收治的T1~3 No Mo 期70例乳腺癌患者，依照数字法随机分成观察组(35例)和对照组(35例)。分别为术前以纳米炭混悬液行经上臂逆行腋窝淋巴结示踪术组(观察组)和行经典腋窝淋巴结清扫术的对照组，比较两组疗效和预后。结果观察组术后1、4周及6个月患侧比健侧上肢臂围增加的百分比为(1.8±0.8)%、(1.8±0.7)%、(1.0±0.3)%，较对照组的(4.7±1.2)%、(4.5±1.1)%、(3.0±0.8)%减少更加明显(P<0.05)。观察组术后预防上肢淋巴水肿的效果的优良率为97.14%(34/35)，明显高于对照组的71.43%(25/35)(P<0.05)。观察组对于上肢淋巴水肿预防情况评分由(63.2±11.4)分改善至(87.3±10.3)分，明显高于对照组(P<0.05)，差异均有统计学意义。结论保留上肢淋巴结的乳腺癌腋窝淋巴结清扫术对预防上肢淋巴水肿效果较好，值得推荐。

Influence of Keep Upper Limb Lymph Nodes Axillary Lymph Node Dissec-tion for Breast Cancer for Preventing Upper Limb Lymph Edema

Objective To study the effect of axillary lymph node dissection on the prevention of upper limb lymph node dis-section in patients with breast cancer. Methods Convenient Selection from January 2014 to June 2015, 70 cases of breast cancer patients with T1~3 NoMo under the premise of patients' informed consent were randomly divided into observation group(35 cases) and control group (35 cases). The control group was given with nano carbon suspension, and the observation group was treated with the retrograde axillary lymph node of the upper arm by the upper arm, compared with the curative effect of the two groups, and prognosis. Results Observation group after operation of 1,4 weeks and 6 months of ipsilateral was more than that of the healthy side upper limb arm around the percentage was increased for (1.8 ±0.8)%, (1.8 ±0.7)%, (1.0±0.3)%, compared with the control group of (4.7±1.2)%,(4.5±1.1)%, (3.0±0.8)%were decreased in the more obvious (P< 0.05). After two groups of operations to prevent the effect of upper limb lymph edema, the observation group was 97.14%(34/35), significantly higher than the control group of 71.43%(25/35)(P<0.05). The two groups of patients after surgery, pa-tients with upper limb lymphatic edema prevention were improved, but the observation group by (63.2 ± 11.4) points im-proved to (87.3 ±10.3) points, improved the degree was significantly higher than the control group (P< 0.05). Conclusion Keep upper limb lymph nodes axillary lymph node dissection for breast cancer for preventing upper limb lymph edema has good effect, worth to be recommended.