CAJ | 학술논문

目的：探讨早期阶段性功能锻炼对乳腺癌改良根治术后患者上肢功能障碍康复效果的影响。方法选择2010年1月~2014年1月东莞市人民医院收治入院的实施乳腺癌改良根治术患者610例，根据功能锻炼方法不同分为两组，观察组340例患者实行早期阶段性患肢功能锻炼，对照组270例患者实行传统的功能锻炼。观察两组患者运动耐力情况、患肢肩关节活动度以及术后并发症。并对所得数据进行统计学分析。结果两组患者术前肩关节前屈、外展、内旋、外旋、内收、后伸等活动度比较，差异无统计学意义(P>0.05)；观察组术后5 d、1个月、3个月、6个月肩关节前屈、外展、外旋、后伸等活动度与对照组同时间段比较，差异均有统计学意义(P<0.05)；观察组术后5 d、3个月、6个月肩关节内旋活动度与对照组同时间段比较，差异均有统计学意义(P<0.05)；观察组患者术后1个月运动后心率恢复时间明显低于对照组，差异有统计学意义(P<0.05)；观察组术后1个月运动后最大心率时间、距离、主观用力感觉与对照组比较，差异无统计学意义(P>0.05)；观察组患者术后3个月运动距离和主观用力感觉明显高于对照组，运动后心率恢复时间明显低于对照组，差异均有统计学意义(P<0.05)；观察组术后3个月运动后最大心率时间与对照组比较，差异无统计学意义(P>0.05)；两组患者术后皮下积液及皮瓣坏死比较，差异无统计学意义(P>0.05)，上肢水肿情况比较，差异有统计学意义(P<0.05)。结论乳腺癌术后早期阶段性个体化患肢功能锻炼可明显降低上肢功能障碍的发生率，有利于促进运动耐力和肢体功能恢复。
목적：탐토조기계단성공능단련대유선암개량근치술후환자상지공능장애강복효과적영향。방법선택2010년1월~2014년1월동완시인민의원수치입원적실시유선암개량근치술환자610례，근거공능단련방법불동분위량조，관찰조340례환자실행조기계단성환지공능단련，대조조270례환자실행전통적공능단련。관찰량조환자운동내력정황、환지견관절활동도이급술후병발증。병대소득수거진행통계학분석。결과량조환자술전견관절전굴、외전、내선、외선、내수、후신등활동도비교，차이무통계학의의(P>0.05)；관찰조술후5 d、1개월、3개월、6개월견관절전굴、외전、외선、후신등활동도여대조조동시간단비교，차이균유통계학의의(P<0.05)；관찰조술후5 d、3개월、6개월견관절내선활동도여대조조동시간단비교，차이균유통계학의의(P<0.05)；관찰조환자술후1개월운동후심솔회복시간명현저우대조조，차이유통계학의의(P<0.05)；관찰조술후1개월운동후최대심솔시간、거리、주관용력감각여대조조비교，차이무통계학의의(P>0.05)；관찰조환자술후3개월운동거리화주관용력감각명현고우대조조，운동후심솔회복시간명현저우대조조，차이균유통계학의의(P<0.05)；관찰조술후3개월운동후최대심솔시간여대조조비교，차이무통계학의의(P>0.05)；량조환자술후피하적액급피판배사비교，차이무통계학의의(P>0.05)，상지수종정황비교，차이유통계학의의(P<0.05)。결론유선암술후조기계단성개체화환지공능단련가명현강저상지공능장애적발생솔，유리우촉진운동내력화지체공능회복。
Objective To investigate the effects of early stage functional exercise on rehabilitation of patients with breast cancer modified radical surgery. Methods 610 cases of patients with modified radical mastectomy admitted to the People's Hospital of Dongguan City from January 2010 to January 2014, and they were divided into two groups ac-cording to functional training methods, 340 cases of the observation group with early stages of limb function were im-plemented exercise, 270 cases of patients in the control group were given the functions of traditional training methods. Exercise tolerance, the limb shoulder range of motion, and postoperative complications were observed. The data was statistically analyzed. Results The shoulder flexion, abduction, internal rotation, external rotation, adduction, extension and other activities of the comparison before surgery of patients in the two groups was not statistically significant (P>0.05); there were statistically significant differences between the two groups in 5 d, 1 month, 3 months, 6 months of shoulder flexion, abduction, external rotation, extension and other activity (P<0.05);the shoulder joint activity of 5 d, 3 months, 6 months after operation in the two groups were compared, the differences were statistically significant (P<0.05);1 month heart rate recovery after exercise of patients in the observation group was significantly lower than that of the control group, the difference was statistically significant (P< 0.05). Maximum heart rate time, distance, subjective feeling in 1 month exercise after operation in the two groups had no statistically significant difference (P> 0.05); dis-tance, subjective feeling of patients 3 month exercise after operation of the observation group were significantly lower than those of the control group, and the differences were statistically significant (P<0.05); maximum heart rate time in 3 months exercise after operation of the two groups had no statistically significant difference (P> 0.05). The postopera-tive seroma and skin flap necrosis of two groups was not significant different (P> 0.05); difference in upper extremity edema was statistically significant (P< 0.05). Conclusion Early stage breast cancer after limb function individualized exercise can significantly reduce the incidence of upper limb dysfunction, and promote sports endurance and recovery of limb function.