《中国康复理论与实践》

《中国康复理论与实践》 ›› 2025, Vol. 31 ›› Issue (10): 1234-1240.doi: 10.3969/j.issn.1006-9771.2025.10.015

• 应用研究 • 上一篇    

不同初始肿胀部位乳腺癌相关淋巴水肿的特异性危险因素

谢娜1, 李丽2, 贾杰2,3()   

  1. 1.北京大学国际医院康复医学科，北京市 102206
    2.上海市静安区中心医院康复医学科，上海市 200040
    3.复旦大学附属华山医院康复医学科，上海市 200040
  • 收稿日期:2025-06-29 修回日期:2025-09-12 出版日期:2025-10-25 发布日期:2025-11-10
  • 通讯作者: 贾杰(1966-)，女，汉族，河南新乡市人，博士，博士后，教授，博士研究生导师，主任医师，E-mail： shannonjj@126.com
  • 作者简介:谢娜(1989-)，女，汉族，山西运城市人，博士研究生，主治医师，主要研究方向：乳腺癌康复、骨关节康复。
  • 基金资助:
    上海市静安区培育学科项目(2024PY02)

Specific risk factors among initial swelling sites of breast cancer-related lymphedema

XIE Na1, LI Li2, JIA Jie2,3()   

  1. 1. Department of Rehabilitation, Peking University International Hospital, Beijing 102206, China
    2. Department of Rehabilitation, Jing'an District Centre Hospital of Shanghai, Shanghai 200040, China
    3. Department of Rehabilitation, Huashan Hospital, Fudan University, Shanghai 200040, China
  • Received:2025-06-29 Revised:2025-09-12 Published:2025-10-25 Online:2025-11-10
  • Contact: JIA Jie, E-mail: shannonjj@126.com
  • Supported by:
    Shanghai Jing'an Cultivating Disciplines Project(2024PY02)

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摘要：

目的 探讨不同初始肿胀部位(胸壁、上臂、前臂、手)乳腺癌相关淋巴水肿(BCRL)患者的临床特征以及特异性危险因素。
方法 回顾性分析2015年12月至2024年3月在上海市静安区中心医院130例BCRL患者，按初始肿胀部位分组，比较基线特征、治疗方式、水肿指标及上肢功能障碍发生情况。
结果 胸壁组样本量过少(n = 2)，不纳入统计分析。其他3组基线特征、治疗方式、水肿指标及上肢功能障碍发生情况均无显著性差异。多因素Logistic回归分析显示，年龄(OR = 1.059, P = 0.013)和水肿发生时间(OR = 0.984, P = 0.011)为上臂初始肿胀的独立相关因素；水肿发生时间(OR = 1.014, P = 0.011)为前臂初始肿胀的独立危险因素；肩关节活动受限(OR = 0.125, P = 0.044)为手部初始肿胀的独立保护因素。
结论 BCRL患者的年龄、水肿发生时间和肩关节功能可能影响肿胀初始发生部位；肿胀初始发生部位可能提示不同的水肿病因。

关键词: 乳腺癌, 淋巴水肿, 肿胀部位, 危险因素

Abstract:

Objective To explore the clinical characteristics and specific risk factors of breast cancer-related lymphedema (BCRL) patients with different initial swelling sites (chest wall, upper arm, forearm and hand).
Methods A total of 130 BCRL inpatients in Jing'an District Centre Hospital of Shanghai from December, 2015 to March, 2024 were reviewed. The patients were grouped by initial swelling sites; baseline characteristics, treatment methods, edema indicators and upper limb dysfunction were compared among groups.
Results The sample size of the chest wall group was too small (n = 2), so it was excluded from the statistical analysis. There was no significant difference in baseline characteristics, treatment methods, edema indicators or the upper limb dysfunction among the other three groups. Multivariate Logistic regression analysis showed that: age (OR = 1.059, P = 0.013) and edema onset time (OR = 0.984, P = 0.011) were the independent related factors for initial swelling in the upper arm, edema onset time (OR = 1.014, P = 0.011) was the independent risk factor for initial swelling in the forearm, and limitation of shoulder motion (OR = 0.125, P = 0.044) was the independent protective factor for initial swelling in the hand.
Conclusion Age, edema onset time and shoulder joint function of BCRL patients may affect the initial sites of swelling. The initial sites of swelling may indicate different etiologies of edema.

Key words: breast cancer, lymphedema, swelling sites, risk factors

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