乳腺癌术后上肢淋巴水肿发病的危险因素

目的  分析乳腺癌术后上肢淋巴水肿（breast cancer related lymphedema，BCRL）发生的危险因素。 方法  随访2008年7月―2019年11月蚌埠医学院第一附属医院甲乳外科收住的62例乳腺癌患者，采用5点周径测量法结合Norman问卷评估上肢淋巴水肿发生情况，结合患者临床资料分析BCRL发生的危险因素。 结果  62例患者中发生上肢淋巴水肿22例（35.5%），轻度水肿20例，中度水肿2例；单因素分析结果提示BCRL与患者的年龄、体重指数（body mass index，BMI）、腋窝淋巴结清扫数量、腋窝第Ⅲ组淋巴结清扫及手术时间有关（均有P < 0.05）；多因素多分类Logistic回归分析模型分析结果提示患者的年龄、BMI及手术时间是BCRL发生的独立危险因素（均有P < 0.05）。 结论  乳腺癌患者术后早期即可发生上肢淋巴水肿，尤其是对于年龄≥53岁、BMI≥27 kg/m²及术后时间≥6月的患者，应积极采取预防性干预措施，以预防和减少BCRL的发生。

Analysis of the incidence and risk factors of breast cancer-related upper limb lymphedema in postoperative patients

  Objective  The purpose of this study was to explore the risk factors of breast cancer-related upper limb lymphedema (BCRL) in postoperative patients.  Methods  There were 62 patients were enrolled from the First Affiliated Hospital of Bengbu Medical College in the present study from July 2008 to November 2019. The 5-point circumference measurement method combined with the Norman questionnaire to assess the occurrence of upper extremity lymphedema, and to analyze the incidence and risk factors of BCRL according to the clinical data.  Results  Of the 62 patients, upper limb lymphedema occurred in 22 (35.5%), 20 had mild edema, and 2 had moderate edema. Univariate analysis results suggest that BCRL is related to the patient's age, body mass index (BMI), number of axillary lymph node dissection, axillary group Ⅲ lymph node dissection, and postoperative time (all P < 0.05). Binary logistic multivariate analysis results suggest that age, BMI, and postoperative time are independent risk factors for BCRL (all P < 0.05).  Conclusions  BCRL had a certain incidence, and it can occur in the early postoperative period, especially for patients age ≥ 53 years old, BMI ≥ 27 kg/m2, and those who accepted operation more than 6 months, preventive interventions should be action taken to prevent and reduce the occurrence of BCRL.