發(fā)布時間：2018-10-26 07:05

【摘要】：目的:觀察乳腺癌患者術后肩關節(jié)功能障礙的發(fā)病情況,并探討其發(fā)生相關的影響因素。方法:對166例2010-2011年在蘇州大學附屬第二醫(yī)院普外科接受手術治療的初治單側(cè)乳腺癌患者的臨床資料進行回顧性分析,并采用調(diào)整的Constant Murley肩關節(jié)評分量表對患者術后的肩關節(jié)功能進行評估。乳腺癌患者肩關節(jié)功能評分量表的得分用(x?s)表示,肩關節(jié)功能分級標準:完全正常為70-75分,非常好為65-69分,良好為55-64分,一般為45-54分,低于45分則為功能極差。肩關節(jié)功能障礙影響因素的單因素分析采用差異性比較或相關性分析的方法,多因素分析采用多重線性回歸分析方法。P0.05為差異具有統(tǒng)計學意義。結果:整組患者均為女性,乳腺癌中位發(fā)病年齡為51(25-74)歲,隨訪與手術中位時間間隔為57(41-73)月。入組患者的調(diào)整的CMS評分平均為(68.7±7.5)分。根據(jù)肩關節(jié)功能評分結果,乳腺癌患者術后肩關節(jié)功能完全正常的病例數(shù)有95例,占57.2%;肩關節(jié)功能非常好的有37例,占22.3%;肩關節(jié)功能良好的有26例,占15.7%;肩關節(jié)功能一般的有6例,占3.6%;僅2例(1.2%)患者出現(xiàn)肩關節(jié)功能極差。多因素分析發(fā)現(xiàn),乳腺癌患者的發(fā)病年齡越大,其肩關節(jié)功能量表得分越低(P=0.041);同樣,接受乳腺癌改良根治術和術后輔助放療的患者,其肩關節(jié)功能量表的得分低(P0.05);而患者的受教育程度對肩關節(jié)功能量表的得分有顯著的正向影響(P=0.008)。結論:乳腺癌患者術后肩關節(jié)功能障礙的發(fā)病率仍然較高,但以輕度功能障礙為主�；颊叩陌l(fā)病年齡大、受教育程度低、接受乳腺癌改良根治術及輔助性放療是肩關節(jié)功能障礙發(fā)生的獨立危險因素。
[Abstract]:Objective: to observe the incidence of shoulder dysfunction in patients with breast cancer after operation and to explore the related factors. Methods: the clinical data of 166 patients with primary unilateral breast cancer received surgical treatment in the second affiliated Hospital of Suzhou University from 2010 to 2011 were retrospectively analyzed. The function of shoulder joint after operation was evaluated by modified Constant Murley shoulder scoring scale. The score of shoulder function scale for breast cancer patients is expressed by (xs). The standard of shoulder function grading is 70-75 points for complete normal, 65-69 points for very good, 55-64 points for good, 45-54 points for general. Lower than 45 points for the function of the extremely poor. The single factor analysis of shoulder dysfunction was analyzed by the method of difference comparison or correlation analysis, and the multivariate analysis by multiple linear regression analysis. P0.05 was statistically significant. Results: all the patients were female. The median age of breast cancer was 51 (25-74) years. The median interval between follow-up and operation was 57 (41-73) months. The adjusted CMS score was (68.7 鹵7.5) points. According to the results of shoulder function score, there were 95 cases (57.2%) with normal shoulder function after breast cancer, 37 cases (22.3%) with excellent shoulder function. 26 cases (15.7%) had good function of shoulder joint, 6 cases (3.6%) had normal function of shoulder joint, and only 2 cases (1.2%) had extremely poor function of shoulder joint. Multivariate analysis showed that the older the age of onset of breast cancer, the lower the score of shoulder function scale (P0. 041). Similarly, the patients receiving modified radical mastectomy and postoperative adjuvant radiotherapy had lower scores of shoulder function scale (P0.05), while the education level of patients had a significant positive effect on the score of shoulder joint function scale (P0. 008). Conclusion: the incidence of shoulder dysfunction in patients with breast cancer is still high, but mild dysfunction is the main disease. The patients were older and less educated. Modified radical mastectomy and adjuvant radiotherapy were independent risk factors for shoulder dysfunction.
【學位授予單位】：蘇州大學
【學位級別】：碩士
【學位授予年份】：2016
【分類號】：R737.9

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