乳腺癌改良根治术后加速康复外科指导功能锻炼对上肢功能的改善效果

目的观察乳腺癌患者改良根治术后加速康复外科(ERAS)指导功能锻炼对上肢功能的恢复效果。方法选取行乳腺癌改良根治术的200例女性乳腺癌患者为研究对象,将其随机分为对照组和实验组,每组100例,分别采用传统功能锻炼和ERAS模式功能锻炼。观察2组术区引流量、住院时间以及患侧上肢水肿情况,比较2组患侧上肢功能恢复效果。结果2组术区引流量比较,差异无统计学意义(P>0.05);实验组住院时间短于对照组,术后2、4周患侧上肢水肿发生率低于对照组,差异均有统计学意义(P<0.05);2组术后4周患侧上肢功能均较术后2周改善,实验组术后2、4周患侧上肢外展、前伸、后伸的活动夹角大于对照组,手指爬墙高度高于对照组,差异均有统计学意义(P<0.05)。结论乳腺癌改良根治术后ERAS功能锻炼能降低患侧上肢水肿发生率,促进功能恢复,缩短住院时间。

Effect of enhanced recovery after surgery for functional exercise guidance in improving upper limb function after modified radical mastectomy

Objective To observe the effect of enhanced recovery after surgery(ERAS)for functional exercise guidance in improving upper limb function after modified radical mastectomy.Methods A total of 200 female patients with breast cancer who underwent modified radical mastectomy were selected as study objects,and were randomly divided into control group and experimental group,with 100 cases in each group,given traditional functional exercise and ERAS,respectively.The drainage volume,hospitalization time and upper limb edema of the affected side in the two groups were observed.The recovery effects of upper limb function were compared in two groups.Results There was no significant difference in drainage volume between the two groups(P>0.05).The hospitalization time of the experimental group was significantly shorter,and the incidence rates of upper limb edema of the affected side were significantly lower at 2 and 4 weeks after operation than the control group(P<0.05).The upper limb function of the affected side in the two groups at 4 weeks after operation was significantly improved compared with that at 2 weeks after operation(P<0.05).The motion angles of abduction,forward extension and backward extension of the affected upper limb in the experimental group were significantly greater,and the heights of finger climbing wall were significantly higher than that in the control group at 2 and 4 weeks after operation(P<0.05).Conclusion ERAS for functional exercise after modified radical mastectomy can reduce the incidence of upper limb edema,promote functional recovery and shorten hospital stay.