手法淋巴引流联合肌内效贴对乳腺癌患者术后康复水平的影响

何熙梅; 曹亚臣; 周香; 叶志强

doi:10.16766/j.cnki.issn.1674-4152.003850

手法淋巴引流联合肌内效贴对乳腺癌患者术后康复水平的影响

doi: 10.16766/j.cnki.issn.1674-4152.003850

温州医科大学附属第一医院乳腺外科，浙江温州 325000

基金项目:

浙江省自然基金基础公益研究项目 LQ22h160022

详细信息

通讯作者:
何熙梅，E-mail：59296877@qq.com

中图分类号: R737.9 R730.9
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- 文章访问数: 35
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- 被引次数: 0
出版历程
- 收稿日期: 2024-01-15
- 网络出版日期: 2025-02-13

Study on the clinical effect of manual lymphatic drainage combined with intramuscular sticking on postoperative rehabilitation of breast cancer patients

Department of Breast Surgery, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang 325000, China

摘要

摘要: 目的为提高乳腺癌术后康复水平，探索手法淋巴引流联合肌内效贴用于乳腺癌术后患者的临床效果。方法纳入2020年1月—2022年12月于温州医科大学附属第一医院实施乳腺癌手术患者130例，采用随机数表法分为研究组(65例)和对照组(65例)，2组均进行分阶段康复训练，在此基础上，研究组实施手法淋巴引流联合肌内效贴治疗。测定患者干预前后肩关节活动度，评价干预后生活质量、肩关节功能、运动耐力水平，统计患者上肢水肿发生情况。结果研究组干预后前屈、外展、内收和后伸等肩关节活动度均显著高于对照组(P < 0.001)；研究组乳腺癌患者生命质量评价表(FACT-B)评分和Constant-Murley评分[(118.37±10.79)分、(88.95±7.46)分]均显著高于对照组[(105.92±10.36)分、(80.46±7.03)分，P < 0.001]；研究组最大心率持续时间、6 min步行距离和Gunnar Borg评分均显著优于对照组，而心率恢复时间则显著短于对照组(P < 0.001)；研究组干预期间上肢水肿发生率显著低于对照组[9.23%(6/65) vs. 23.08%(15/65), χ²=4.600，P=0.032]。结论在康复训练基础上实施手法淋巴引流联合肌内效贴治疗，可提高乳腺癌患者术后肩关节功能恢复水平，改善生活质量，增强运动耐力，并有助于降低上肢水肿发生风险。
- 乳腺癌 /
- 康复训练 /
- 手法淋巴引流 /
- 肌内效贴 /
- 肩关节功能 /
- 上肢水肿
Abstract: Objective In order to improve the postoperative rehabilitation level of breast cancer patients, to explore the clinical effect of manual lymphatic drainage combined with intramuscular plaster in such patients. Methods A total of 130 patients who underwent breast cancer surgery in the First Affiliated Hospital of Wenzhou Medical University from January 2020 to December 2022 were included, and divided into study group (65 cases) and control group (65 cases). The control group patients were undergone staged rehabilitation training, and on this basis, the study group patients were received the implementation of manual lymphatic drainage combined with intramuscular effect patch therapy intervention. The changes in shoulder joint mobility of patients before and after intervention were measured. The quality of life, shoulder joint function, and exercise endurance level after intervention were evaluated. The occurrence of upper limb edema in patients during the intervention period were counted. Results After intervention, the range of motion of shoulder joint (flexion, abduction, adduction, and extension) in the study group was significantly higher than those in the control group (P < 0.001). The functional assessment of cancertherapy-breast (FACT-B) score and Constant-Murley score of the study group [(118.37±10.79) points, (88.95±7.46) points] were significantly higher than those of the control group [(105.92±10.36) points, (80.46±7.03) points, P < 0.001]. The maximum heart rate duration, 6-minute walking distance, and Gunnar Borg score in the study group were significantly longer or higher than those in the control group, while the heart rate recovery time was significantly shorter than that in the control group (P < 0.001). The incidence of upper limb edema during the intervention period in the study group was significantly lower than that in the control group [9.23% (6/65) vs. 23.08% (15/65), χ²=4.600, P=0.032]. Conclusion On the basis of rehabilitation training, manual lymphatic drainage combined with intramuscular effect patch can improve the recovery level of shoulder joint function of patients with breast cancer after surgery, improve the quality of life, enhance sports endurance, and help reduce the risk of upper limb edema.
- Breast cancer /
- Rehabilitation training /
- Manual lymphatic drainage /
- Intramuscular effect patch /
- Shoulder joint function /
- Upper limb edema

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表 1 2组乳腺癌根治术患者干预前后肩关节活动度比较(x±s，°)

Table 1. Comparison of shoulder joint range of motion before and after intervention between two groups of patients with radical mastectomy(x±s, °)

组别	例数	前屈		外展		内收		后伸
组别	例数	干预前	干预1个月后	干预前	干预1个月后	干预前	干预1个月后	干预前	干预1个月后
研究组	65	45.68±8.75	74.16±7.35^b	68.29±7.18	153.92±14.86^b	38.75±3.91	67.17±6.46^b	21.42±2.76	46.39±4.18^b
对照组	65	45.32±8.69	65.49±6.61^b	68.53±6.94	139.58±14.21^b	39.16±4.02	59.36±6.04^b	21.63±2.64	37.84±3.92^b
统计量		0.235^a	19.374^c	0.194^a	14.861^c	0.589^a	17.692^c	0.401^a	23.472^c
P值		0.814	< 0.001	0.847	< 0.001	0.557	< 0.001	0.653	< 0.001
注：^a为t值，^c为F值；与同组干预前比较，^bP < 0.05。

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表 2 2组乳腺癌根治术患者干预前后FACT-B评分和Constant-Murley评分比较(x±s，分)

Table 2. Comparison of FACT-B score and Constant Murley score before and after intervention between two groups of patients with radical mastectomy(x±s, points)

组别	例数	FACT-B评分		Constant-Murley评分
组别	例数	干预前	干预1个月后	干预前	干预1个月后
研究组	65	76.51±6.28	118.37±10.79^b	59.02±5.68	88.95±7.46^b
对照组	65	77.04±6.42	105.92±10.36^b	58.69±5.74	80.46±7.03^b
统计量		0.426^a	18.457^c	0.395^a	15.396^c
P值		0.639	< 0.001	0.742	< 0.001
注：^a为t值，^c为F值；与同组干预前比较，^bP < 0.05。

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表 3 2组乳腺癌根治术患者干预后运动耐力情况比较(x±s)

Table 3. Comparison of exercise endurance after intervention between two groups of patients with radical mastectomy(x±s)

组别	例数	最大心率持续时间(min)	6分钟步行距离(m)	心率恢复时间(min)	Gunnar Borg评分(分)
研究组	65	5.52±0.69	324.63±29.65	6.13±0.74	11.56±1.39
对照组	65	4.37±0.61	259.08±24.73	9.04±1.12	9.42±1.07
t值		10.067	13.688	17.477	9.836
P值		< 0.001	< 0.001	< 0.001	< 0.001

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