穴位按摩结合自我淋巴引流预防乳腺癌术后上肢淋巴水肿的临床研究

目的 探索穴位按摩结合自我淋巴引流技术预防乳腺癌术后上肢淋巴水肿的临床效果。方法 选取2017年4月至2018年5月在江苏省肿瘤医院乳腺外科行乳腺癌手术的患者68例，按时间段进行分组，36例患者进行自我淋巴引流，32例患者在自我淋巴引流的基础上，配合大陵、内关、外关、尺泽、曲泽等穴位按摩。采用手臂周径测量法评估两组患者术后6个月、12个月、18个月患侧肢体肿胀症状、淋巴水肿是否发生以及发生程度。结果 自我淋巴引流组有6例（16.7%）患者发生轻度水肿，穴位按摩结合自我引流组仅1例（3.1%）患者发生轻度水肿，发生时间在术后6～12个月不等，两组淋巴水肿的发生率差异有统计学意义（P＜0.05）。结论 穴位按摩结合自我淋巴引流技术预防乳腺癌术后上肢淋巴水肿的效果优于单纯实施自我淋巴引流。

Prevention of breast cancer-related lymphedema by the method of acupressure combined with lymphatic drainage

Objective To explore the clinical effects of acupressure and self-manual lymph drainage on the prevention of breast cancer-related lymphedema. Methods A total of 68 consecutive patients treated with breast cancer surgery from April 2017 to May 2018 in Jiangsu Cancer Hospital were enrolled and divided into two groups. Of all the patients underwent self-manual lymph drainage, 32 patients were treated with acupoint massage on Daling, Neiguan, Waiguan, Chize and Quze. The arm circumference measurement method was used to evaluate the symptoms and the degree of lymphedema in patients among the three groups at the 6th, 12th and 18th month after operation. Results Mild lymphedema occurred in 6 patients in the self-manual lymph drainage group. One patient occurred mild edema in the self- manual lymph drainage plus acupoint massage group. The occurrence time ranged from 6 to 12 months after surgery. There was statistical difference between the self- manual lymph drainage group and the other two groups in the occurrence rate of lymphedema(P<0.05). Conclusion The effect of self-manual lymph drainage combined with acupoint massage was better than that of self-lymphatic drainage.