乳腺癌术后腋网综合征识别与诊断标准中国专家共识

doi:10.3969/j.issn.1006-9771.2026.00.003

《中国康复理论与实践》 ›› 2026, Vol. 32 ›› Issue (8): 882-891.doi: 10.3969/j.issn.1006-9771.2026.00.003

• 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识别与诊断标准中国专家共识

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委员会

收稿日期:2026-02-09 修回日期:2026-02-24 接受日期:2026-02-24 出版日期:2026-08-25 发布日期:2026-05-11
基金资助:
国家自然科学基金地区基金项目(82560019);国家科技重大专项(2025ZD0548904);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 identification and diagnostic criteria for axillary web syndrome after breast cancer surgery

Received:2026-02-09 Revised:2026-02-24 Accepted:2026-02-24 Published:2026-08-25 Online:2026-05-11
Supported by:
National Natural Science Foundation of China Regional Science Fund Project(82560019);National Science and Technology Major Projects(2025ZD0548904);Key International Science and Technology Cooperation Project of Henan Province(261111521500);Henan Province Medical Science and Technology Research Program, 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(2025YLZDJH190);Zhuhai Social Development Field Science and Technology Plan(2320004000143)

摘要/Abstract

摘要：

目的基于循证方法，制定乳腺癌术后腋网综合征(AWS)的识别与诊断标准。

方法由多学科专家组成共识小组，采用Delphi法进行两轮专家函询。系统检索国内外相关文献，采用GRADE系统对证据质量进行分级，并结合专家临床经验，形成推荐意见。

结果本共识围绕AWS的筛查、西医诊断、中医辨证、危险因素、病理生理及发展以及与淋巴水肿的关系6个核心维度，最终形成13条推荐意见。

结论本共识建立AWS的标准化识别和诊断体系，可为临床实践提供循证依据和结构化建议，有助于推动我国AWS康复的规范化和精准化。

关键词: 乳腺癌, 腋网综合征, 康复, 诊断标准, 专家共识

Abstract:

Objective To establish identification and diagnostic criteria for axillary web syndrome (AWS) after breast cancer surgery using evidence-based medicine methods.

Methods A multidisciplinary consensus panel was formed. Two rounds of Delphi-based expert consultation were conducted. Relevant literatures were systematically reviewed, and the GRADE system was utilized to assess the quality of the evidence. Final recommendations were formulated through a synthesis of the evidence and expert clinical judgment.

Results There were six core dimensions of screening for AWS, diagnosis in Western medicine, syndrome differentiation in traditional Chinese medicine, risk factors, pathophysiology and progression, and its relationship with lymphedema, with a total of 13 recommendations addressing.

Conclusion This consensus establishes a standardized framework for identifying and diagnosing AWS following breast cancer surgery. It provides an evidence-based foundation and structured recommendations for clinical practice, which will contribute to standardizing and refining post-operative AWS rehabilitation in China.

Key words: breast cancer, axillary web syndrome, rehabilitation, diagnostic criteria, 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委员会. 乳腺癌术后腋网综合征识别与诊断标准中国专家共识[J]. 《中国康复理论与实践》, 2026, 32(8): 882-891.

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. Chinese expert consensus on identification and diagnostic criteria for axillary web syndrome after breast cancer surgery[J]. Chinese Journal of Rehabilitation Theory and Practice, 2026, 32(8): 882-891.

图/表 1

参考文献 56

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阶段	时间范围	病理变化	临床表现	典型显像模式(Roman 2022)
术后早期	0~4周	淋巴管及伴行静脉损伤，局部高凝致血栓形成	腋窝牵拉痛或紧绷感，可触及细条索，肩外展轻度受限	功能性淋巴减退
术后中期	1~2月	血栓机化，炎症活跃，转化生长因子-β/Smad通路激活致纤维化形成	条索明显、紧张，疼痛及活动受限最显著	淋巴管阻塞，无侧支形成
恢复期	2~6月	炎症吸收、部分淋巴再通，肌成纤维细胞活性下降，胶原降解增加	条索变软、可滑动，疼痛缓解，关节活动度改善	淋巴管侧支新生，伴或不伴真皮内淋巴液流动增加
慢性期	≥ 6月	胶原纤维交叉沉积、局灶钙化，淋巴循环功能不全，淋巴再通障碍	条索质硬，肩外展受限改善但仍不及健侧	稳定或不完全再通状态

乳腺癌术后腋网综合征识别与诊断标准中国专家共识

Chinese expert consensus on identification and diagnostic criteria for axillary web syndrome after breast cancer surgery

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