林琳

【摘要】 目的：探讨术后早期阶段性功能锻炼对老年乳腺癌改良根治术后患侧上肢功能恢复的干预效果。方法：选择2016年1月-2018年8月在笔者所在医院接受乳腺癌改良根治术的老年患者96例，按照手术日期的单双日分为对照组（n=48）和观察组（n=48），对照组术后进行常规恢复锻炼，观察组在对照组基础上使用术后早期阶段性功能锻炼，对比患者恢复效果。结果：干预前，两组患侧上肢肩关节活动度比较差异无统计学意义（P>0.05）;干预后两组肩关节活动度均高于干预前，且观察组高于对照组，差异均有统计学意义（t=-88.233、-20.234、-35.296、-79.678，P<0.05）。观察组术后各类并发症发生率均低于对照组，差异均有统计学意义（字2=4.414、6.095、4.444、P<0.05）。结论：使用术后早期阶段性功能锻炼干预接受乳腺癌改良根治术的老年患者，可以改善患侧上肢功能恢复的效果，减少术后并发症。

【关键词】 功能锻炼 乳腺癌 上肢功能 手术

doi：10.14033/j.cnki.cfmr.2019.28.059 文献标识码 B 文章编号 1674-6805（2019）28-0-03

Interventional Effect of Early Postoperative Sexual Function Exercise on Recovery of Upper Limb Function in Elderly Patients with Modified Radical Mastectomy/LIN Lin. //Chinese and Foreign Medical Research， 2019， 17（28）： -142

[Abstract] Objective： To investigate the effect of early postoperative sexual function exercise on the recovery of upper limb function in elderly patients with modified radical mastectomy. Method： A total of 96 elderly patients who underwent modified radical mastectomy in our hospital from January 2016 to August 2018 were enrolled. According to the single and double days of the operation date， they were divided into the control group （n=48） and the observation group （n=48）. The control group underwent routine recovery exercise after operation， and the observation group used postoperative early stage sexual exercise on the basis of the control group. The effect of patient recovery were compared. Result： Before intervention， there was no significant difference of the activity of shoulder joints between the two groups （P>0.05）. After intervention， the activity of shoulder joints was higher than that before intervention， and the differences were statistically significant （t=-88.233， -20.234， -35.296， -79.678， P<0.05）. The incidence of postoperative complications in the observation group were lower than those in the control group， the differences were statistically significant （字2=4.414， 6.095， 4.444， P<0.05）. Conclusion： Elderly patients undergoing modified radical mastectomy with early postoperative functional exercise can improve the recovery of upper limb function and reduce postoperative complications.

[Key words] Functional exercise Breast cancer Upper limb function Surgery

First-authors address： The 900th Hospital of the Joint Service Support Force of the PLA （Former 476 Clinical Department）， Fuzhou 350000， China

乳腺癌早已成為我国乃至全球范围内女性的高发恶性肿瘤。但是在以往的研究中，针对乳腺癌的研究多集中在育龄期妇女的年龄段内，而对于罹患乳腺癌的老年人群研究相对较为薄弱。随着我国人口老龄化程度不断加大，老年乳腺癌患病率逐年递增，研究结果显示乳腺癌病死率已经成为老年女性恶性肿瘤的首位，严重影响了人群健康[1-3]。临床工作中针对乳腺癌的治疗方法较多，如手术，化疗，放疗，靶向治疗，免疫治疗等[4-5]。其中乳腺癌改良根治术是目前最为主要的手术方法。尽管该方法的效果显著，但是对乳房的切除不仅导致患者失去第二性征，也会对患侧上肢功能造成一定影响，这会使患者的生活质量降低，同时加大心理负担[6-7]。目前认为接受乳腺癌改良根治术后及早进行功能锻炼对于功能恢复具有重要的意义，而采用何种方法锻炼，又存在不小的争议。有鉴……