朱永翠 徐康 程丽萍

[摘要] 目的 探討手法淋巴引流法联合功能康复锻炼对乳腺癌术后患肢功能恢复的临床疗效。 方法 选择2019年3月至2020年9月于景德镇市第一人民医院行乳腺癌改良根治术患者60例，按随机数字表法将研究对象随机分为对照组和观察组，每组各30例。对照组术后康复以功能锻炼为主，观察组在对照组的基础上另行手法淋巴引流法，干预周期为3个月，比较干预前后两组患肢淋巴水肿、疼痛、患肢相关角度、前位爬行高度差、侧位爬行高度差等。 结果 观察组肿胀发生率为10.00%，低于对照组的20.00%，差异有统计学意义（P<0.05）。两组干预前疼痛评分比较，差异无统计学意义（P>0.05），干预后观察组疼痛评分为（2.05±0.32）分，低于对照组的（3.13±0.14）分，差异有统计学意义（P<0.05）。干预前两组前屈、外展、内旋、外旋、内收、后伸角度比较，差异无统计学意义（P>0.05），干预后，两组以上角度均上升，观察组上升高于对照组，差异有统计学意义（P<0.05）。观察组干预前后前位爬行高度差、侧位爬行高度差分别为（37.15±3.23）cm、（36.35±3.06）cm，高于对照组的（32.12±2.45）cm、（31.24±2.12）cm，差异有统计学意义（P<0.05）。 结论 手法淋巴引流法联合功能康复锻炼更有利于乳腺癌术后改善术后患肢水肿、提高耐力、促进患肢功能恢复、提高乳腺癌术后患者的生活质量。

[关键词] 乳腺癌;手法淋巴引流;康复锻炼;功能恢复

[中图分类号] R737.9          [文献标识码] A          [文章编号] 1673-9701（2021）30-0029-05

[Abstract] Objective To explore the clinical efficacy of manual lymphatic drainage combined with functional rehabilitation exercise on the functional recovery of the affected limbs of patients after breast cancer surgery. Methods A tatol of 60 patients underwent modified radical mastectomy in Jingdezhen No.1 People′s Hospital from March 2019 to September 2020 were selected.They were randomly divided into the control group and the observation group according to the random number table，with 30 cases in each group.The control group received functional exercise，while the observation group was treated with manual lymphatic drainage on the basis of the control group. Both groups were intervened for 3 months. The lymphedema，pain，related angles，difference in anterior crawling height and difference in lateral crawling height of the affected limb were compared between the two groups before and after intervention. Results The incidence of swelling in the observation group was 10.00%，which was lower than that in the control group（20.00%）， with statistically significant difference（P<0.05）.There was no difference in pain score between the two groups before intervention （P>0.05）.After intervention，the pain score of the observation group was（2.05±0.32） points，which was lower than that of the control group （3.13±0.14） points，with statistically significant difference （P<0.05）. Before intervention， the angles of flexion， abduction，internal rotation，external rotation，adduction and extension in the two groups had no statistical significance（P>0.05）. After intervention，the angles of the above indicators of the two groups were increased，and the increase of the observation group was higher than that of the control group，with statistically significant difference（P<0.05）.Before and after intervention，the difference of anterior crawling height and lateral crawling height in the observation group was （37.15±3.23） cm and （36.35±3.06）cm，which were higher than those in the control group [（32.12±2.45）cm and （31.24±2.12）cm]，with statistically significant differences （P<0.05）. Conclusion Manual lymphatic drainage combined with functional rehabilitation exercise is more conducive to improving postoperative edema of affected limbs，improving endurance，promoting functional recovery of affected limbs and improving the quality of life of patients after breast cancer surgery.

[Key words] Breast cancer; Manual lymphatic drainage; Rehabilitation exercise; Function recovery

乳腺癌占据女性恶性肿瘤发病率及死亡率首位，其发病率约为24.2%[1]。乳腺癌改良根治术是目前乳腺外科治疗乳腺癌最普遍的手术方式，手术中需进行腋窝淋巴结清扫，容易造成腋窝淋巴组织的损伤，影响淋巴液正常回流，从而导致肿胀的发生，造成上肢功能障碍。……