本文選題：浸潤性導管癌 + 上肢淋巴水腫�。� 參考：《山東中醫(yī)藥大學》2017年碩士論文

【摘要】：研究目的:本研究通過回訪乳腺浸潤性導管癌術(shù)后患者臨床資料,分析并探討有關患側(cè)上肢淋巴水腫的危險因素、發(fā)病機制以及治療策略,為乳腺浸潤性導管癌術(shù)后上肢淋巴水腫的治療提供可靠的臨床依據(jù)。研究方法:1.收集2015年1月1日至2016年12月30日山東中醫(yī)藥大學附屬醫(yī)院腫瘤科門診及病房接受治療的乳腺浸潤性導管癌患者臨床資料,了解術(shù)后淋巴水腫發(fā)生情況。2.制定回訪表格,回訪記錄患者手術(shù)、術(shù)后、治療、水腫、轉(zhuǎn)歸和預后等情況,根據(jù)研究目的進行統(tǒng)計分析和探討。3.分析李秀榮教授的治療經(jīng)驗探討乳腺浸潤性導管癌術(shù)后上肢淋巴水腫的相關危險因素、發(fā)病機制以及預后情況,以求為臨床治療策略提供理論基礎。研究結(jié)果:通過對92例乳腺浸潤性導管癌術(shù)后患者的研究表明:1.術(shù)后發(fā)生上肢淋巴水腫者32例(水腫組,占34%),術(shù)后未發(fā)生上肢淋巴水腫者60例(非水腫組,占66%);兩組在年齡、BMI指數(shù)、內(nèi)分泌治療、術(shù)后放療、術(shù)后感染分布中具有統(tǒng)計學差異(P0.05)。2.logistic回歸分析表明:與浸潤性導管癌術(shù)后上肢淋巴水腫有關系的因素為:年齡、BMI指數(shù)、感染及放療。3.危險因素越少,患者水腫程度越輕,水腫分期越低;危險因素越多,患者的水腫程度越重,水腫分期越高。4.臨床上乳腺浸潤性導管癌術(shù)后上肢淋巴水腫以中度水腫較為常見,中醫(yī)藥對于防治中度水腫具有一定優(yōu)勢。研究結(jié)論:1.除手術(shù)必然性因素外,乳腺浸潤性導管癌術(shù)后上肢淋巴水腫的主要危險因素是高齡、肥胖、感染及放療,有效控制體重以及預防感染對于防治乳腺浸潤性導管癌術(shù)后上肢淋巴水腫具有積極作用。2.“虛”、“瘀”、“濕”不僅與“蛋白沉積”“脂肪沉積”“纖維化”等病理改變相關,同時也是推動淋巴水腫發(fā)展的病理產(chǎn)物�！敖∑⒗麧瘛焙汀盎钛觥笔欠乐稳橄俳䴘櫺詫Ч馨┬g(shù)后上肢淋巴水腫的基本原則,從“虛”“瘀”“濕”著手,應用中藥防治乳腺浸潤性導管癌術(shù)后上肢淋巴水腫具有重大意義。
[Abstract]:Objective: to investigate the risk factors, pathogenesis and treatment strategy of lymphedema in the upper extremity of breast cancer patients after breast invasive ductal carcinoma surgery. To provide a reliable clinical basis for the treatment of upper limb lymphedema after breast invasive ductal carcinoma. Research method: 1. From January 1, 2015 to December 30, 2016, the clinical data of breast invasive ductal carcinoma patients treated in the oncology department of affiliated Hospital of Shandong University of traditional Chinese Medicine were collected to understand the incidence of lymphedema after operation. Make a return visit form, record the operation, postoperative, treatment, edema, outcome and prognosis of patients, according to the purpose of the study statistical analysis and discussion. 3. To explore the risk factors, pathogenesis and prognosis of lymphedema in upper extremity after operation of invasive ductal carcinoma of breast, and to provide a theoretical basis for clinical treatment. Study results: 92 patients with invasive ductal carcinoma of the breast after surgery showed that: 1. 1. There were 32 cases of upper limb lymphedema (edema group, 34 cases) and 60 cases of no upper limb lymphedema (non-edema group, 66%). Logistic regression analysis showed that the factors associated with upper limb lymphedema after operation for invasive ductal carcinoma were age BMI index, infection and radiotherapy. The less risk factors, the lighter the degree of edema, the lower the stage of edema, and the more risk factors, the more serious the degree of edema, the higher the stage of edema. 4. Moderate edema is common in upper limb lymphedema after operation of invasive ductal carcinoma of breast. Chinese medicine has some advantages in preventing and treating moderate edema. Conclusion: 1. In addition to surgical necessity, the main risk factors for upper limb lymphedema after breast invasive ductal carcinoma surgery were old age, obesity, infection and radiotherapy. Effective control of body weight and prevention of infection in the prevention and treatment of breast invasive ductal carcinoma after the upper limb lymphedema has a positive role. "deficiency", "stasis" and "dampness" are not only related to the pathological changes such as "protein deposition", "fat deposition" and "fibrosis", but also the pathological products that promote the development of lymphedema. "invigorating spleen and promoting dampness" and "promoting blood circulation and removing blood stasis" are the basic principles of preventing and treating upper limb lymphedema after operation of invasive ductal carcinoma of mammary glands, starting with "deficiency", "stasis" and "dampness". It is of great significance to prevent and treat upper limb lymphedema after operation of breast invasive ductal carcinoma with Chinese medicine.
【學位授予單位】：山東中醫(yī)藥大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R737.9

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相關期刊論文 前10條

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