地奧斯明治療乳腺癌上肢淋巴水腫臨床觀察

謝春華 石少權 楊光偉 曾慶安 劉星偉

(1.珠海市人民醫院,廣東 珠海519000;2.中山大學附屬第五醫院,廣東 珠海519000 )

[摘要]目的 探討地奧斯明對治療乳腺癌手術及術后放療引起上肢淋巴水腫的臨床療效。方法 對56例乳腺癌手術及術后放射治療引起的上肢淋巴水腫患者采用地奧斯明。結果 總緩解率為100%,完全緩解率為64.3%(36/56),部分緩解率為30.4%(17/56),輕度緩解率為3.6%(3/56)。輕/中度水腫緩解率為100%(48/48),重度水腫緩解率為62.5%(5/8),二者差異有統計學意義,P=0.001。單純手術后和術后放療后水腫緩解率分別為100%(29/29)和88.9%(24/27),二者差異有統計學意義,P=0.001。術后放射治療發生重度淋巴水腫患者無完全緩解病例。結論 地奧斯明能使乳腺癌手術及術后放療引起的上肢淋巴水腫減輕、消退,淋巴水腫程度愈輕療效愈好,術后放療且重度淋巴水腫患者療效不佳。

[關鍵詞] 乳腺腫瘤/放射療法;淋巴水腫;地奧斯明

[中圖分類號] R737.9 [文獻標識碼] A [文章編號] 1004-8650(2009)05-098-02

The study of the clinical efficacy of Diosmin to arm lymphedema induced by radical operation and postoperative radiotherapy of breast cancer

XIE Chun-Hua,SHI Shao-Quan,YANG Guan-Wei, ZENG Qin-An, LIU Xin-Wei

(XIE Chun -Hua: Department of Genneral Surgery,the Zhai Hai Peoples Hospital,zhuhai,China 519000)

[Abstract] Objective To study the Diosmin clinical efficacy to arm lymphedema induced by radical operation and postoperative radiotherapy of breast cancer. Methods Fifty-six breast cancer patients of arm lymphedema induced by radical operation and postoperative radiotherapy were treated with Diosmin.Results Objective confirmed responses were observed in 56 patients(100%), including 36 complete responses (64.3%) and 17 partial responses (30.4%). The response rate of soft moderate arm lymphedema and hard lymphedema was 100%(48/48) and 62.5%(5/8),respectively.The arm lymphedema of single postoperative of breast cancer was 100%(29/29); postoperative radiotherapy cancer patientswas 88.9%(24/27). There was obvious difference of response between soft/moderate and hard lymphedema (P=0.001) aswell as single postoperative and postoperative radiotherapy cancer patients,P =0.001. There was no any comp lete response case in the hard lymphedema of postoperative radiotherapy cancer patients. Conclusion Diosmin therapy can relieve the arm lymphedema of postoperative and radiotherapy of breast cancer,the gentler of lymphedema,and the better efficacy is,postoperative radiotherapy of breast cancer with hard lymphedema got low response.

[Key words] breast neoplasms /radiotherapy;Diosmin;lymphedema

乳腺癌根治術后上肢淋巴水腫是最常見的并發癥之一,發病率為6.7%-62.5%。由于手術破壞腋窩解剖結構,術后放射治療進一步加劇局部組織纖維化的形成,患側上肢血液、淋巴液回流障礙,上肢淋巴水腫在手術后6個月即可出現且進行性加重,造成患肢功能障礙或喪失,生活質量下降,而功能鍛煉和藥物治療效果又不甚理想。我科對56例乳腺癌手術及術后放射治療引起的上肢淋巴水腫患者采用地奧斯明治療,使上肢淋巴水腫得到一定程度的緩解,結果總結報道如下。

1對象與方法