乳腺癌患者术后患肢功能状况的纵向研究

目的探讨乳腺癌患者术后患肢功能的状况及变化规律。方法采用便利抽样法,抽取在本院住院的80例乳腺癌术后患者,采用上臂和肩关节功能自我评定量表分别于术前、术后3个月、术后6个月、术后1年对患者进行测评,并同时测评其肩关节活动度。结果术前、术后3个月、术后6个月、术后1年不同时间点患者肩关节活动度水平及上臂和肩关节功能自我评定得分比较,差异有统计学意义(P<0.001),两两比较结果显示,术后3个月分别与术前、术后6个月、术后1年比较,差异有统计学意义(P<0.0083);术后6个月分别与术前、术后3个月、术后1年比较,差异有统计学意义(P<0.0083);术后1年分别与术后3个月、术后6个月比较,差异有统计学意义(P<0.0083);术前与术后1年比较,除肩关节后伸度外,其余差异有统计学意义(P<0.0083)。患者的肩关节活动度及上臂和肩关节功能自我评定得分均于术后3个月最低。结论乳腺癌患者术后患肢功能康复水平是动态变化的,术后3个月为最低水平,随着术后时间延长,之后逐渐上升,但至术后1年仍未恢复至术前水平。需加强乳腺癌患者术后患肢功能的管理,延长随访时间,以提升患者患肢功能水平,进而提高康复效果。

Longitudinal study on affected limb function in breast cancer patients within one year after surgery

Objective To investigate the status and changes of affected limb function in breast cancer patients within one year after surgery. Methods A total of 80 breast cancer patients who were admitted to a Class One grade A oncology hospital in Guangzhou were sampled out by convenient sampling method. The patients were evaluated by self-rating scale of upper arm and shoulder joint function(SRSUASJF) before surgery, 3 months after surgery, 6 months after surgery and 1 year after surgery, and the motion of shoulder joint was evaluated. Results There were statistically significant differences in the level of motion of shoulder joint and the score of SRSUASJF at different time points(P <0.001). Pairwise comparison results showed that the difference was statistically significant(P <0.0083) between 3 months after surgery before surgery, and 6 months after surgery and 1 year after surgery. The difference was statistically significant(P <0.0083) between 6 months after surgery and 3 months after surgery and 1 year after surgery. The difference was statistically significant(P<0.0083) between 1 year after surgery and 3 months after surgery and 6 months after surgery. Preoperative and postoperative 1 year, there was statistically significant difference except back extension of shoulder joint( P <0.0083). The self assessment score of patients with shoulder joint activity and upper arm and shoulder joint function of in postoperative 3 months was at a minimum level. Conclusions The limb function after surgery for breast cancer rehabilitation is dynamic, postoperative 3 months to the lowest level, as the postoperative time extended, it rosed gradually. But it recovered to preoperative levels to postoperative 1 years still need to strengthen the management of limb function after surgery for breast cancer patients.A longer follow-up period was needed to enhance the level of patients with limb function and then improve the effect of Kant’s.