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、运动耐力及生命质量的影响
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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、运动耐力及生命质量的影响。方法选取本院2015年7月至2017年7月收治的94例老年乳腺癌患者为研究对象,按照随机数表法将其分为观察组和对照组,每组各47例。两组患者均行乳腺癌改良根治术。对照组患者术后采用常规功能锻炼,观察组患者术后采用早期阶段性功能锻炼。比较两组患者术前和术后3个月患侧肢体肩关节活动度、运动耐力、生命质量各量表评分及术后并发症发生情况。结果术后3个月,观察组患者患侧肢体肩关节前屈、后伸、内收、外展活动度均显著大于对照组(P_均<0.05),运动后最大心率时间显著长于对照组(P <0.05),运动后心率恢复时间短于对照组(P <0.05),运动距离长于对照组(P <0.05),生命质量量表各项评分均显著高于对照组(P_均<0.05),术后并发症发生率显著低于对照组(P <0.05)。结论术后早期阶段性功能锻炼有助于促进老年乳腺癌患者运动耐力和患侧上肢功能恢复,改善患者生命质量,值得临床研究。
Objective To explore the effect of early stage functional exercise on functional recovery of affected upper limb, exercise tolerance and quality of life of elderly patients undergoing modified radical mastectomy. Method 94 elderly patients with breast cancer admitted to our hospital from July 2015 to July 2017 were selected as the subjects. They were divided into observation group and control group according to random number table method, 47 cases in each group. Modi?ed radical mastectomy was performed in both groups. Control group patients were given routine functional exercises after operation, observation group patients were given early stage functional exercises after operation. The range of motion, exercise endurance, quality of life scales and complications of shoulder joint of affected limbs before and 3 months after operation were compared between the two groups. Result 3 months after operation,the shoulder joint ?exion, extension, adduction and abduction of the affected limbs in observation group were signi?cantly greater than those in control group(P_(all)< 0.05), the maximum heart rate time after exercise was signi?cantly longer than that in control group(P < 0.05), the heart rate recovery time after exercise was shorter than that in control group(P < 0.05), the exercise distance was longer than that in control group(P < 0.05), and the scores of quality of life scale were signi?cantly higher than that in control group(P_(all)< 0.05), the incidence of postoperative complications was signi?cantly lower than that in control group(P < 0.05). Conclusion Early stage functional exercise after operation is helpful to promote the exercise endurance and recovery of upper limb function in elderly patients with breast cancer, and to improve the quality of life of patients, which is worthy of clinical study.
Objective To explore the effect of early stage functional exercise on functional recovery of affected upper limb, exercise tolerance and quality of life of elderly patients undergoing modified radical mastectomy. Method 94 elderly patients with breast cancer admitted to our hospital from July 2015 to July 2017 were selected as the subjects. They were divided into observation group and control group according to random number table method, 47 cases in each group. Modi?ed radical mastectomy was performed in both groups. Control group patients were given routine functional exercises after operation, observation group patients were given early stage functional exercises after operation. The range of motion, exercise endurance, quality of life scales and complications of shoulder joint of affected limbs before and 3 months after operation were compared between the two groups. Result 3 months after operation,the shoulder joint ?exion, extension, adduction and abduction of the affected limbs in observation group were signi?cantly greater than those in control group(P_(all)< 0.05), the maximum heart rate time after exercise was signi?cantly longer than that in control group(P < 0.05), the heart rate recovery time after exercise was shorter than that in control group(P < 0.05), the exercise distance was longer than that in control group(P < 0.05), and the scores of quality of life scale were signi?cantly higher than that in control group(P_(all)< 0.05), the incidence of postoperative complications was signi?cantly lower than that in control group(P < 0.05). Conclusion Early stage functional exercise after operation is helpful to promote the exercise endurance and recovery of upper limb function in elderly patients with breast cancer, and to improve the quality of life of patients, which is worthy of clinical study.
引文
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[17]钱丽芳,刘学朴,赵杏珍,等.乳腺癌根治术后患肢功能锻炼方法及效果评价[J].现代临床护理,2015,14(3):66-69.
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[19]叶锦荷.乳腺癌改良根治术后早期阶段性功能锻炼对患者康复效果的影响[J].中国医药导报,2015,13(2):61-64.
[20]方仁桂,王建军,占小平,等.术后早期、阶段性功能锻炼对乳腺癌改良根治术后患侧上肢功能恢复的影响[J].重庆医学,2017,46(21):2917-2920.
[2]王乐,张玥,石菊芳,等.中国女性乳腺癌疾病负担分析[J].中华流行病学杂志,2016,37(7):970-976.
[3]许燕岚,陈伟.乳腺癌基因治疗研究进展[J].四川生理科学杂志,2015,37(4):212-214.
[4]Gupta K,Srikanth K,Girdhar KK,et al.Analgesic efficacy of ultrasound-guided paravertebral block versus serratus plane block for modified radical mastectomy:A randomised,controlled trial[J].Indian J Anaesth,2017,61(5):381-386.
[5]王美,张琦,杜琛,等.肩梯在乳腺癌改良根治术后患者患肢功能锻炼中的应用及效果[J].解放军护理杂志,2018,35(7):65-68.
[6]苏红革,孙素琴,牛丹,等.乳腺癌改良根治术后患者上肢功能锻炼的效果观察[J].中国妇幼保健,2013,28(14):2333-2334.
[7]袁凤玲,黄焕葵,张顺欢.阶段性功能锻炼操对乳腺癌术后患者康复效果的影响[J].深圳中西医结合杂志,2016,26(8):12-14.
[8]孙达统,王琳,曾爱辉,等.新辅助化疗ET方案联合扩张皮瓣对局限性晚期乳腺癌根治术患者的影响[J].肿瘤药学,2017,7(4):470-474.
[9]景红娟,金玉凤,叶燕萍,等.乳腺癌根治术后应用多西紫杉醇联合卡培他滨化疗及心理干预的临床观察[J].中国生化药物杂志,2017,37(8):298-299.
[10]Huang YS,Chen JL,Huang CS,et al.High mammographic breast density predicts locoregional recurrence after modified radical mastectomy for invasive breast cancer:a case-control study[J].Breast Cancer Res,2016,18(1):120.
[11]Mwakigonja AR,Rabiel H,Mbembati NA,et al.The pattern of prognostic and risk indicators among women with breast cancer undergoing modified radical mastectomy in Dar es Salaam,Tanzania[J].Infect Agent Cancer,2016,11:28.
[12]Jonnavithula N,Khandelia H,Durga P,et al.Role of wound instillation with bupivacaine through surgical drains for postoperative analgesia in modified radical mastectomy[J].Indian J Anaesth,2015,59(1):15-20.
[13]Chen Z,Xu Y,Shu J,et al.Breast-conserving surgery versus modified radical mastectomy in treatment of early stage breast cancer:A retrospective study of 107 cases[J].J Cancer Res Ther,2015,11 Suppl 1:C29-C31.
[14]Grunwald Z,Moore JH,Schwartz GF.Bilateral brachial plexus palsy after a right-side modified radical mastectomy with immediate TRAM flap reconstruction[J].Breast J,2015,9(1):41-43.
[15]李青春,薛军花.早期康复功能锻炼对乳腺癌根治术患者术后患肢功能恢复及肩关节活动度的影响分析[J].医药前沿,2017,7(10):19-21.
[16]刘卉.早期功能锻炼对乳腺癌术后患肢功能恢复的效果评价[J].中华全科医学,2016,14(9):1598-1600.
[17]钱丽芳,刘学朴,赵杏珍,等.乳腺癌根治术后患肢功能锻炼方法及效果评价[J].现代临床护理,2015,14(3):66-69.
[18]叶美娜.早期阶段性功能锻炼对乳腺癌改良根治术后患者康复效果的影响[J].中国基层医药,2015,6(12):1771-1773.
[19]叶锦荷.乳腺癌改良根治术后早期阶段性功能锻炼对患者康复效果的影响[J].中国医药导报,2015,13(2):61-64.
[20]方仁桂,王建军,占小平,等.术后早期、阶段性功能锻炼对乳腺癌改良根治术后患侧上肢功能恢复的影响[J].重庆医学,2017,46(21):2917-2920.