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.	陈万青, 郑荣寿. 中国女性乳腺癌发病死亡和生存状况. 中国肿瘤临床, 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.	时华, 薛萍, 薛桂凤, 等. 早期护理干预对乳腺癌根治术后并发症的效果观察. 实用临床医药杂志, 2014, 14(22): 151-152.
4.	刘飞, 路潜, 欧阳倩, 等. 乳腺癌患者术后淋巴水肿与其相关症状的关系研究. 中华护理杂志, 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.	刘晓溪, 王世宣. 乳腺癌术后上肢淋巴水肿的发生因素分析与护理. 护士进修杂志, 2016, 31(8): 715-717.
7.	金明子, 周愉, 曹红平, 等. 激光针治疗乳腺癌相关淋巴水肿的临床研究. 中国医药导报, 2017, 14(20): 101-104.
8.	陈澎涛. 乳腺癌患者术后上肢淋巴水肿的危险因素分析. 中国医药科学, 2015, 9(6): 363-366.
9.	林哲莹, 黄东娜, 李旭恋, 等. 空气波压力治疗仪预防乳腺癌术后上肢淋巴水肿的效果观察. 现代医院, 2014, 14(5): 57-58.
10.	朱倩男, 夏添松, 凌立君, 等. 乳腺癌术后上肢淋巴水肿发生机制及预防进展. 中华乳腺病杂志(电子版), 2013, 7(6): 442-445.
11.	郭勇. 改良静脉淋巴管吻合技术在乳腺癌术后上肢淋巴水肿中的临床价值. 中国现代普通外科进展, 2016, 19(11): 889-891.
12.	唐冰, 许丽, 李海红. 乳腺癌根治术后上肢淋巴水肿测量方法的研究. 实用临床医药杂志, 2016, 20(12): 168-169, 172.
13.	李光明, 段百芸, 许云宝, 等. 乳腺癌患者术后感染特征与危险因素分析. 中华医院感染学杂志, 2016, 26(2): 390-392.
14.	时华. 早期护理干预对乳腺癌根治术后并发症的效果观察. 实用临床医药杂志, 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, 张颖, 杜金刚, 等. 速肌力训练对乳腺癌术后淋巴水肿的疗效观察. 中国康复, 2015, 30(3): 201-203.
17.	王伟. 中药内服外敷治疗乳腺癌术后上肢淋巴水肿临床观察. 实用中医药杂志, 2016, 32(10): 958-959.
18.	吴文通, 王芳, 钱尤. 黄芪桂枝五物汤合当归芍药散治疗乳腺癌术后上肢水肿80例. 浙江中西医结合杂志, 2016, 26(2): 130-131.
19.	王志华, 赵建娥, 张腾华, 等. 乳腺癌腋窝淋巴结清扫术中选择性保留上肢淋巴结对预防上肢淋巴水肿的作用. 中国普外基础与临床杂志, 2011, 18(6): 646-650.
20.	Torres Lacomba M, Yuste Sánchez MJ, Zapico Goñi 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.	苏久龙, 潘翠环, 曹腾飞, 等. 抗阻呼吸训练对乳腺癌术后上肢淋巴水肿的疗效. 中国康复理论与实践, 2016, 22(11): 1318-1321.
23.	战祥毅, 隋鑫, 王文萍. 中医治疗乳腺癌术后上肢淋巴水肿研究进展. 临床军医杂志, 2017, 45(2): 216-220.
24.	臧荟然, 毕晔, 穆简. 乳腺癌术后上肢淋巴水肿的治疗与预防进展. 中国修复重建外科杂志, 2016, 30(12): 1567-1570.
25.	丁玎, 张勃, 谢瑛. 综合康复对乳腺癌术后淋巴水肿的疗效. 中国康复理论与实践, 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, 杨赶梅, 张子理, 等. 中药热奄包治疗乳腺癌术后上肢淋巴水肿临床研究. 实用中医药杂志, 2015, 31(8): 774, 775.
28.	王惠雪, 李惠萍, 杨娅娟, 等. 乳腺癌术后淋巴水肿预防行为相关临床实践指南现况及内容研究. 中国全科医学, 2017, 20(6): 639-644.
29.	陈佳佳, 汪立, 于子优, 等. 手法淋巴引流治疗乳腺癌术后上肢淋巴水肿. 组织工程与重建外科, 2015, 11(5): 310-312.
30.	王玲, 汪苗, 周丽华. 乳腺癌腋窝淋巴结清扫术后上肢淋巴水肿相关症状研究. 中华乳腺病杂志(电子版), 2017, 11(2): 87-91.
31.	郑建伟, 蔡淑艳, 宋慧敏, 等. 乳腺癌患者术后上肢淋巴水肿的危险因素分析. 中华乳腺病杂志(电子版), 2015, 9(6): 363-366.

1. 陈万青, 郑荣寿. 中国女性乳腺癌发病死亡和生存状况. 中国肿瘤临床, 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. 时华, 薛萍, 薛桂凤, 等. 早期护理干预对乳腺癌根治术后并发症的效果观察. 实用临床医药杂志, 2014, 14(22): 151-152.
4. 刘飞, 路潜, 欧阳倩, 等. 乳腺癌患者术后淋巴水肿与其相关症状的关系研究. 中华护理杂志, 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. 刘晓溪, 王世宣. 乳腺癌术后上肢淋巴水肿的发生因素分析与护理. 护士进修杂志, 2016, 31(8): 715-717.
7. 金明子, 周愉, 曹红平, 等. 激光针治疗乳腺癌相关淋巴水肿的临床研究. 中国医药导报, 2017, 14(20): 101-104.
8. 陈澎涛. 乳腺癌患者术后上肢淋巴水肿的危险因素分析. 中国医药科学, 2015, 9(6): 363-366.
9. 林哲莹, 黄东娜, 李旭恋, 等. 空气波压力治疗仪预防乳腺癌术后上肢淋巴水肿的效果观察. 现代医院, 2014, 14(5): 57-58.
10. 朱倩男, 夏添松, 凌立君, 等. 乳腺癌术后上肢淋巴水肿发生机制及预防进展. 中华乳腺病杂志(电子版), 2013, 7(6): 442-445.
11. 郭勇. 改良静脉淋巴管吻合技术在乳腺癌术后上肢淋巴水肿中的临床价值. 中国现代普通外科进展, 2016, 19(11): 889-891.
12. 唐冰, 许丽, 李海红. 乳腺癌根治术后上肢淋巴水肿测量方法的研究. 实用临床医药杂志, 2016, 20(12): 168-169, 172.
13. 李光明, 段百芸, 许云宝, 等. 乳腺癌患者术后感染特征与危险因素分析. 中华医院感染学杂志, 2016, 26(2): 390-392.
14. 时华. 早期护理干预对乳腺癌根治术后并发症的效果观察. 实用临床医药杂志, 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, 张颖, 杜金刚, 等. 速肌力训练对乳腺癌术后淋巴水肿的疗效观察. 中国康复, 2015, 30(3): 201-203.
17. 王伟. 中药内服外敷治疗乳腺癌术后上肢淋巴水肿临床观察. 实用中医药杂志, 2016, 32(10): 958-959.
18. 吴文通, 王芳, 钱尤. 黄芪桂枝五物汤合当归芍药散治疗乳腺癌术后上肢水肿80例. 浙江中西医结合杂志, 2016, 26(2): 130-131.
19. 王志华, 赵建娥, 张腾华, 等. 乳腺癌腋窝淋巴结清扫术中选择性保留上肢淋巴结对预防上肢淋巴水肿的作用. 中国普外基础与临床杂志, 2011, 18(6): 646-650.
20. Torres Lacomba M, Yuste Sánchez MJ, Zapico Goñi 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. 苏久龙, 潘翠环, 曹腾飞, 等. 抗阻呼吸训练对乳腺癌术后上肢淋巴水肿的疗效. 中国康复理论与实践, 2016, 22(11): 1318-1321.
23. 战祥毅, 隋鑫, 王文萍. 中医治疗乳腺癌术后上肢淋巴水肿研究进展. 临床军医杂志, 2017, 45(2): 216-220.
24. 臧荟然, 毕晔, 穆简. 乳腺癌术后上肢淋巴水肿的治疗与预防进展. 中国修复重建外科杂志, 2016, 30(12): 1567-1570.
25. 丁玎, 张勃, 谢瑛. 综合康复对乳腺癌术后淋巴水肿的疗效. 中国康复理论与实践, 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, 杨赶梅, 张子理, 等. 中药热奄包治疗乳腺癌术后上肢淋巴水肿临床研究. 实用中医药杂志, 2015, 31(8): 774, 775.
28. 王惠雪, 李惠萍, 杨娅娟, 等. 乳腺癌术后淋巴水肿预防行为相关临床实践指南现况及内容研究. 中国全科医学, 2017, 20(6): 639-644.
29. 陈佳佳, 汪立, 于子优, 等. 手法淋巴引流治疗乳腺癌术后上肢淋巴水肿. 组织工程与重建外科, 2015, 11(5): 310-312.
30. 王玲, 汪苗, 周丽华. 乳腺癌腋窝淋巴结清扫术后上肢淋巴水肿相关症状研究. 中华乳腺病杂志(电子版), 2017, 11(2): 87-91.
31. 郑建伟, 蔡淑艳, 宋慧敏, 等. 乳腺癌患者术后上肢淋巴水肿的危险因素分析. 中华乳腺病杂志(电子版), 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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