乳腺癌术后腋网综合征治疗与管理规范中国专家共识(2025)

doi:10.3969/j.issn.1006-9771.2026.00.002

《中国康复理论与实践》 ›› 2026, Vol. 32 ›› Issue (8): 869-881.doi: 10.3969/j.issn.1006-9771.2026.00.002

• 专题乳腺癌术后腋网综合征康复 • 上一篇下一篇

乳腺癌术后腋网综合征治疗与管理规范中国专家共识(2025)

中国康复医学会青年工作委员会, 中国微循环学会周围血管委员会淋巴水肿专家委员会, 中国抗癌协会肿瘤康复整合护理专业专委会, 中国康复医学会社区康复工作委员会

收稿日期:2026-02-09 修回日期:2026-02-24 接受日期:2026-03-27 出版日期:2026-08-25 发布日期:2026-05-11
基金资助:
国家卫健委医药卫生科技发展研究中心2030重大专项(WKZX2023HK0109);河南省国际科技合作重点项目(261111521500);河南省医学科技攻关计划项目省部共建重点项目(SBGJ202502103);河南省科技攻关项目(262102310181);郑州市医疗卫生领域科技创新指导计划项目(2025YLZDJH190);珠海市社会发展领域科技计划项目(2320004000143)

Chinese expert consensus on rehabilitation and management of axillary web syndrome following breast cancer surgery (2025)

Received:2026-02-09 Revised:2026-02-24 Accepted:2026-03-27 Published:2026-08-25 Online:2026-05-11
Supported by:
National Health Commission Medical and Health Science and Technology Development Research Center 2030 Major Special Project(WKZX2023HK0109);Key International Science and Technology Cooperation Project of Henan Province(261111521500);Henan Province Medical Science and Technology Research Program Project, Provincial and Ministerial Co-construction Key Project(SBGJ202502103);Science and Technology Research Project of Henan Province(262102310181);Zhengzhou City Medical and Health Field Science and Technology Innovation Guidance Program Project(2025YLZDJH190);Zhuhai Social Development Field Science and Technology Plan(2320004000143)

摘要/Abstract

摘要：

目的基于循证方法，形成乳腺癌术后腋网综合征(AWS)康复与管理规范的中国专家共识。

方法成立共识指导委员会与编写委员会，依据《中国制订/修订临床诊疗指南的指导原则(2022版)》及国际指南报告规范，系统检索相关文献与指南，采用GRADE系统进行证据分级，通过德尔菲法开展两轮专家函询并修订完善，经专家论证会审议形成共识终稿。

结果乳腺癌术后AWS的康复管理需由康复医生、康复治疗师和护理人员等多学科专家协同干预，共识围绕康复评估、康复治疗、教育与管理3个核心领域，形成18条推荐意见。

结论针对乳腺癌术后AWS规范化康复管理相关问题形成专家共识，有助于推动我国AWS康复实践的标准化与同质化。

关键词: 乳腺癌, 腋网综合征, 康复, 管理, 专家共识

Abstract:

Objective To develop a Chinese expert consensus on rehabilitation and management of axillary web syndrome (AWS) following breast cancer surgery using evidence-based methods.

Methods A consensus steering committee and writing committee were set up. Relevant literatures and guidelines were systematically searched in accordance with Principles for the Formulation/Revision of Clinical Practice Guidelines in China (2022 Edition) and Reporting Items for Practice Guidelines in Healthcare statement. Evidence grading was performed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system. Two rounds of expert consultation were carried out using Delphi method for revision and improvement, and the final consensus was formulated after deliberation and approval at an expert seminar.

Results Rehabilitation management of AWS after breast cancer surgery requires multidisciplinary collaborative intervention from rehabilitation physicians, rehabilitation therapists, nurses and other professionals. The consensus includes 18 recommendations covering three core domains: rehabilitation assessment, rehabilitation treatment and education management.

Conclusion The expert consensus addressing the standardized rehabilitation management of AWS after breast cancer surgery would promote the standardization and homogenization of AWS rehabilitation practice in China.

Key words: breast cancer, axillary web syndrome, rehabilitation, management, expert consensus

中图分类号:

R737.9

中国康复医学会青年工作委员会, 中国微循环学会周围血管委员会淋巴水肿专家委员会, 中国抗癌协会肿瘤康复整合护理专业专委会, 中国康复医学会社区康复工作委员会. 乳腺癌术后腋网综合征治疗与管理规范中国专家共识(2025)[J]. 《中国康复理论与实践》, 2026, 32(8): 869-881.

Youth Working Committee of Chinese Association of Rehabilitation Medicine, Lymphedema Expert Committee of Peripheral Vascular Committee of Chinese Society of Microcirculation, Integrated Nursing Professional Committee for Tumor Rehabilitation of Chinese Anti-Cancer Association, Community Rehabilitation Working Committee of Chinese Association of Rehabilitation Medicine. Chinese expert consensus on rehabilitation and management of axillary web syndrome following breast cancer surgery (2025)[J]. Chinese Journal of Rehabilitation Theory and Practice, 2026, 32(8): 869-881.

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Lovett分级法	名称	标准	Kendall百分数分级法(%)
0	零	未触及肌肉收缩	0
1	微弱	有轻微收缩，但不能引起关节活动	10
1⁺	微弱	有强力收缩，但不能引起关节活动	10
2^-	差	在减重状态下能做关节活动，但不能全范围活动	25
2		在减重状态下能做关节全范围活动
2⁺		在减重状态下能做关节全范围活动，并可略微抗重力
3^-	尚可	能抗重力做关节活动，但不能全范围活动，也不能抗阻力	50
3		能抗重力做关节全范围活动，但不能抗阻力
3⁺		能抗重力做关节全范围活动，并可略微抗阻力
4^-	良好	能抗重力和轻度阻力，做关节全范围运动	75
4		能抗重力和适度阻力，做关节全范围运动
4⁺		能抗重力和适度偏大阻力，做关节全范围运动
5^-	正常	能抗重力和充分偏小阻力，做关节全范围运动	100

推荐类别	定位	干预措施	循证级别
一线推荐	基础治疗	徒手筋膜松解手法、软组织松动术、特异性拉伸运动	A/强推荐
一线推荐	增效治疗	徒手淋巴引流术(manual lymphatic drainage, MLD)、渐进式抗阻运动	B/强推荐
二线推荐	备选治疗	徒手按摩、中药热敷	B/强推荐
	备选治疗	刮痧	C/弱推荐
	辅助治疗	多磺酸粘多糖乳膏	B/强推荐
		肌内效贴、心理干预	C/强推荐
		浅层热疗、器械辅助软组织松解术	D/弱推荐

乳腺癌术后腋网综合征治疗与管理规范中国专家共识(2025)

Chinese expert consensus on rehabilitation and management of axillary web syndrome following breast cancer surgery (2025)

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