The preventive effectiveness of air pressure pump combined with the microwave physiotherapy on arm lymphedema after modified radical mastectomy for breast cancer_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

MA Zhiqiang , FAN Junchao , WANG Wensheng , SHI Bingshuai , ZHAO Aiguo , ZHANG Xiaoyang ,  ZHANG Shuanglin

Department of Breast and Thyroid Surgery, The First Affiliated Hospital of Henan University, Kaifeng, Henan 475000, P. R. China;

Corresponding?author：

ZHANG Shuanglin, Email: moon21@126.com

Keywords：

arm lymphedema; physiotherapy; early intervention; modified radical mastectomy for breast cancer

DOI：

10.7507/1007-9424.201708044

Video：

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Objective To explore the preventive effectiveness of early physiotherapy on arm lymphedema after modified radical mastectomy for breast cancer. Methods A total of 206 patients who underwent modified radical mastectomy for breast cancer in The First Affiliated Hospital of Henan University from June 2014 to June 2016, enrolled in this randomized controlled clinical trial. Then these patients were randomly divided into intervention group and control group equally. Patients in the control group received routine treatment, and the patients in the intervention group began to use the air pressure pump combined with the microwave physiotherapy on the second day after the radical surgery. The incidences of limb lymphedema in 6 months and 1 year after operation between the 2 groups were compared, and the influencing factors of arm lymphedema were explored. Results The clinical data of 195 patients were analyzed at end, including 99 patients of the intervention group and 96 patients of the control group. ① There were statistical significance in the incidences of arm lymphedema in 6 months and 1 year after operation between the 2 groups (P<0.05), that incidences of arm lymphedema in the intervention group were both lower than those of the control group at the2 time points [6 months after operation: 2.0% (2/99)vs. 9.4% (9/96); 1 year after operation: 5.1% (5/99) vs. 17.7% (17/96)]. ② The results of non-conditional logistic regression analysis shown that, age (OR=1.45, P=0.008), tumor location (OR=1.72, P<0.001), TNM stage (OR=2.01, P=0.033), the number of invasive axillary lymph nodes (OR=1.15, P=0.005), and postoperative radiotherapy (OR=1.23, P=0.016) were the influencing factors of arm lymphedema after modified radical mastectomy for breast cancer, patients with age older than 60 years, tumor position at the outside area, stage Ⅲ of TNM, the number of invasive axillary lymph nodes >5, and patients received radiotherapy after operation had high risk of arm lymphedema. Conclusion Early physiotherapy can effectively prevent the occurrence of arm lymphedema after modified radical mastectomy for breast cancer, and early physiotherapy should be performed for patients with high risk of arm lymphedema.

Citation： MA Zhiqiang, FAN Junchao, WANG Wensheng, SHI Bingshuai, ZHAO Aiguo, ZHANG Xiaoyang, ZHANG Shuanglin. The preventive effectiveness of air pressure pump combined with the microwave physiotherapy on arm lymphedema after modified radical mastectomy for breast cancer. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2018, 25(2): 191-196. doi: 10.7507/1007-9424.201708044 Copy

1.	陳萬青, 鄭榮壽. 中國女性乳腺癌發病死亡和生存狀況. 中國腫瘤臨床, 2015, 42(13): 668-674.
2.	DiSipio T, Rye S, Newman B, et al. Incidence of unilateral arm lymphoedema after breast cancer: a systematic review and meta-analysis. Lancet Oncol, 2013, 14(6): 500-515.
3.	時華, 薛萍, 薛桂鳳, 等. 早期護理干預對乳腺癌根治術后并發癥的效果觀察. 實用臨床醫藥雜志, 2014, 14(22): 151-152.
4.	劉飛, 路潛, 歐陽倩, 等. 乳腺癌患者術后淋巴水腫與其相關癥狀的關系研究. 中華護理雜志, 2016, 51(5): 518-522.
5.	Ay AA, Kutun S, Cetin A. Lymphoedema after mastectomy for breast cancer: importance of supportive care. S Afr J Surg, 2014, 52(2): 41-44.
6.	劉曉溪, 王世宣. 乳腺癌術后上肢淋巴水腫的發生因素分析與護理. 護士進修雜志, 2016, 31(8): 715-717.
7.	金明子, 周愉, 曹紅平, 等. 激光針治療乳腺癌相關淋巴水腫的臨床研究. 中國醫藥導報, 2017, 14(20): 101-104.
8.	陳澎濤. 乳腺癌患者術后上肢淋巴水腫的危險因素分析. 中國醫藥科學, 2015, 9(6): 363-366.
9.	林哲瑩, 黃東娜, 李旭戀, 等. 空氣波壓力治療儀預防乳腺癌術后上肢淋巴水腫的效果觀察. 現代醫院, 2014, 14(5): 57-58.
10.	朱倩男, 夏添松, 凌立君, 等. 乳腺癌術后上肢淋巴水腫發生機制及預防進展. 中華乳腺病雜志(電子版), 2013, 7(6): 442-445.
11.	郭勇. 改良靜脈淋巴管吻合技術在乳腺癌術后上肢淋巴水腫中的臨床價值. 中國現代普通外科進展, 2016, 19(11): 889-891.
12.	唐冰, 許麗, 李海紅. 乳腺癌根治術后上肢淋巴水腫測量方法的研究. 實用臨床醫藥雜志, 2016, 20(12): 168-169, 172.
13.	李光明, 段百蕓, 許云寶, 等. 乳腺癌患者術后感染特征與危險因素分析. 中華醫院感染學雜志, 2016, 26(2): 390-392.
14.	時華. 早期護理干預對乳腺癌根治術后并發癥的效果觀察. 實用臨床醫藥雜志, 2014, 14(22): 151-152.
15.	Huang TW, Tseng SH, Lin CC, et al. Effects of manual lymphatic drainage on breast cancer-related lymphedema: a systematic review and meta-analysis of randomized controlled trials. World J Surg Oncol, 2013, 11: 15.
16.	李益平, 張穎, 杜金剛, 等. 速肌力訓練對乳腺癌術后淋巴水腫的療效觀察. 中國康復, 2015, 30(3): 201-203.
17.	王偉. 中藥內服外敷治療乳腺癌術后上肢淋巴水腫臨床觀察. 實用中醫藥雜志, 2016, 32(10): 958-959.
18.	吳文通, 王芳, 錢尤. 黃芪桂枝五物湯合當歸芍藥散治療乳腺癌術后上肢水腫80例. 浙江中西醫結合雜志, 2016, 26(2): 130-131.
19.	王志華, 趙建娥, 張騰華, 等. 乳腺癌腋窩淋巴結清掃術中選擇性保留上肢淋巴結對預防上肢淋巴水腫的作用. 中國普外基礎與臨床雜志, 2011, 18(6): 646-650.
20.	Torres Lacomba M, Yuste Sánchez MJ, Zapico Go?i A, et al. Effectiveness of early physiotherapy to prevent lymphoedema after surgery for breast cancer: randomised, single blinded, clinical trial. BMJ, 2010, 340(12): b5396.
21.	Box RC, Reul-Hirche HM, Bullock-Saxton JE, et al. Physiotherapy after breast cancer surgery: results of a randomised controlled study to minimise lymphoedema. Breast Cancer Res Treat, 2002, 75(1): 51-64.
22.	蘇久龍, 潘翠環, 曹騰飛, 等. 抗阻呼吸訓練對乳腺癌術后上肢淋巴水腫的療效. 中國康復理論與實踐, 2016, 22(11): 1318-1321.
23.	戰祥毅, 隋鑫, 王文萍. 中醫治療乳腺癌術后上肢淋巴水腫研究進展. 臨床軍醫雜志, 2017, 45(2): 216-220.
24.	臧薈然, 畢曄, 穆簡. 乳腺癌術后上肢淋巴水腫的治療與預防進展. 中國修復重建外科雜志, 2016, 30(12): 1567-1570.
25.	丁玎, 張勃, 謝瑛. 綜合康復對乳腺癌術后淋巴水腫的療效. 中國康復理論與實踐, 2015, 21(1): 88-90.
26.	Togawa K, Ma H, Sullivan-Halley J, et al. Risk factors for self-reported arm lymphedema among female breast cancer survivors: a prospective cohort study. Breast Cancer Res, 2014, 16(4): 414-418.
27.	金宇, 楊趕梅, 張子理, 等. 中藥熱奄包治療乳腺癌術后上肢淋巴水腫臨床研究. 實用中醫藥雜志, 2015, 31(8): 774, 775.
28.	王惠雪, 李惠萍, 楊婭娟, 等. 乳腺癌術后淋巴水腫預防行為相關臨床實踐指南現況及內容研究. 中國全科醫學, 2017, 20(6): 639-644.
29.	陳佳佳, 汪立, 于子優, 等. 手法淋巴引流治療乳腺癌術后上肢淋巴水腫. 組織工程與重建外科, 2015, 11(5): 310-312.
30.	王玲, 汪苗, 周麗華. 乳腺癌腋窩淋巴結清掃術后上肢淋巴水腫相關癥狀研究. 中華乳腺病雜志(電子版), 2017, 11(2): 87-91.
31.	鄭建偉, 蔡淑艷, 宋慧敏, 等. 乳腺癌患者術后上肢淋巴水腫的危險因素分析. 中華乳腺病雜志(電子版), 2015, 9(6): 363-366.

1. 陳萬青, 鄭榮壽. 中國女性乳腺癌發病死亡和生存狀況. 中國腫瘤臨床, 2015, 42(13): 668-674.
2. DiSipio T, Rye S, Newman B, et al. Incidence of unilateral arm lymphoedema after breast cancer: a systematic review and meta-analysis. Lancet Oncol, 2013, 14(6): 500-515.
3. 時華, 薛萍, 薛桂鳳, 等. 早期護理干預對乳腺癌根治術后并發癥的效果觀察. 實用臨床醫藥雜志, 2014, 14(22): 151-152.
4. 劉飛, 路潛, 歐陽倩, 等. 乳腺癌患者術后淋巴水腫與其相關癥狀的關系研究. 中華護理雜志, 2016, 51(5): 518-522.
5. Ay AA, Kutun S, Cetin A. Lymphoedema after mastectomy for breast cancer: importance of supportive care. S Afr J Surg, 2014, 52(2): 41-44.
6. 劉曉溪, 王世宣. 乳腺癌術后上肢淋巴水腫的發生因素分析與護理. 護士進修雜志, 2016, 31(8): 715-717.
7. 金明子, 周愉, 曹紅平, 等. 激光針治療乳腺癌相關淋巴水腫的臨床研究. 中國醫藥導報, 2017, 14(20): 101-104.
8. 陳澎濤. 乳腺癌患者術后上肢淋巴水腫的危險因素分析. 中國醫藥科學, 2015, 9(6): 363-366.
9. 林哲瑩, 黃東娜, 李旭戀, 等. 空氣波壓力治療儀預防乳腺癌術后上肢淋巴水腫的效果觀察. 現代醫院, 2014, 14(5): 57-58.
10. 朱倩男, 夏添松, 凌立君, 等. 乳腺癌術后上肢淋巴水腫發生機制及預防進展. 中華乳腺病雜志(電子版), 2013, 7(6): 442-445.
11. 郭勇. 改良靜脈淋巴管吻合技術在乳腺癌術后上肢淋巴水腫中的臨床價值. 中國現代普通外科進展, 2016, 19(11): 889-891.
12. 唐冰, 許麗, 李海紅. 乳腺癌根治術后上肢淋巴水腫測量方法的研究. 實用臨床醫藥雜志, 2016, 20(12): 168-169, 172.
13. 李光明, 段百蕓, 許云寶, 等. 乳腺癌患者術后感染特征與危險因素分析. 中華醫院感染學雜志, 2016, 26(2): 390-392.
14. 時華. 早期護理干預對乳腺癌根治術后并發癥的效果觀察. 實用臨床醫藥雜志, 2014, 14(22): 151-152.
15. Huang TW, Tseng SH, Lin CC, et al. Effects of manual lymphatic drainage on breast cancer-related lymphedema: a systematic review and meta-analysis of randomized controlled trials. World J Surg Oncol, 2013, 11: 15.
16. 李益平, 張穎, 杜金剛, 等. 速肌力訓練對乳腺癌術后淋巴水腫的療效觀察. 中國康復, 2015, 30(3): 201-203.
17. 王偉. 中藥內服外敷治療乳腺癌術后上肢淋巴水腫臨床觀察. 實用中醫藥雜志, 2016, 32(10): 958-959.
18. 吳文通, 王芳, 錢尤. 黃芪桂枝五物湯合當歸芍藥散治療乳腺癌術后上肢水腫80例. 浙江中西醫結合雜志, 2016, 26(2): 130-131.
19. 王志華, 趙建娥, 張騰華, 等. 乳腺癌腋窩淋巴結清掃術中選擇性保留上肢淋巴結對預防上肢淋巴水腫的作用. 中國普外基礎與臨床雜志, 2011, 18(6): 646-650.
20. Torres Lacomba M, Yuste Sánchez MJ, Zapico Go?i A, et al. Effectiveness of early physiotherapy to prevent lymphoedema after surgery for breast cancer: randomised, single blinded, clinical trial. BMJ, 2010, 340(12): b5396.
21. Box RC, Reul-Hirche HM, Bullock-Saxton JE, et al. Physiotherapy after breast cancer surgery: results of a randomised controlled study to minimise lymphoedema. Breast Cancer Res Treat, 2002, 75(1): 51-64.
22. 蘇久龍, 潘翠環, 曹騰飛, 等. 抗阻呼吸訓練對乳腺癌術后上肢淋巴水腫的療效. 中國康復理論與實踐, 2016, 22(11): 1318-1321.
23. 戰祥毅, 隋鑫, 王文萍. 中醫治療乳腺癌術后上肢淋巴水腫研究進展. 臨床軍醫雜志, 2017, 45(2): 216-220.
24. 臧薈然, 畢曄, 穆簡. 乳腺癌術后上肢淋巴水腫的治療與預防進展. 中國修復重建外科雜志, 2016, 30(12): 1567-1570.
25. 丁玎, 張勃, 謝瑛. 綜合康復對乳腺癌術后淋巴水腫的療效. 中國康復理論與實踐, 2015, 21(1): 88-90.
26. Togawa K, Ma H, Sullivan-Halley J, et al. Risk factors for self-reported arm lymphedema among female breast cancer survivors: a prospective cohort study. Breast Cancer Res, 2014, 16(4): 414-418.
27. 金宇, 楊趕梅, 張子理, 等. 中藥熱奄包治療乳腺癌術后上肢淋巴水腫臨床研究. 實用中醫藥雜志, 2015, 31(8): 774, 775.
28. 王惠雪, 李惠萍, 楊婭娟, 等. 乳腺癌術后淋巴水腫預防行為相關臨床實踐指南現況及內容研究. 中國全科醫學, 2017, 20(6): 639-644.
29. 陳佳佳, 汪立, 于子優, 等. 手法淋巴引流治療乳腺癌術后上肢淋巴水腫. 組織工程與重建外科, 2015, 11(5): 310-312.
30. 王玲, 汪苗, 周麗華. 乳腺癌腋窩淋巴結清掃術后上肢淋巴水腫相關癥狀研究. 中華乳腺病雜志(電子版), 2017, 11(2): 87-91.
31. 鄭建偉, 蔡淑艷, 宋慧敏, 等. 乳腺癌患者術后上肢淋巴水腫的危險因素分析. 中華乳腺病雜志(電子版), 2015, 9(6): 363-366.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

The preventive effectiveness of air pressure pump combined with the microwave physiotherapy on arm lymphedema after modified radical mastectomy for breast cancer

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