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[乳腺癌腋窝淋巴结清扫术后肩胛肌的肌电活动模式]

[Myoeletric activity pattern of scapular muscles after axillary lymphadenectomy in breast cancer].

作者信息

Pereira Thiago Bezerra, Bergmann Anke, Ribeiro Ana Carolina Padula, Da Silva Júlio Guilherme, Dias Ricardo, Ribeiro Maria Justina Padula, Thuler Luiz Claudio Santos

机构信息

Programa de Pós-graduação em Neurologia, Universidade Federal do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brasil.

出版信息

Rev Bras Ginecol Obstet. 2009 May;31(5):224-9. doi: 10.1590/s0100-72032009000500004.

Abstract

PURPOSE

to identify the pattern of myoelectrical activity of muscles from the scapular region, after axillary lymphadenectomy in breast cancer.

METHODS

prospective cohort study including all the women submitted to axillary lymphadenectomy for surgical treatment of breast cancer, in a breast cancer reference center, from June to August 2006. The women were evaluated before, and after 3 and 12 months from the surgery, through physical and electromyographic examinations of the serratus anterior, upper trapezius and middle deltoid muscles.

RESULTS

the patients' average age was 60.3 years old (DP+/-14.1), and the incidence of winged scapula at the physical examination was 64.9%. At the third-months evaluation, a reduction of 28.3 microV was observed in the myoelectrical activity of the serratus anterior muscle. At the twelveth-months evaluation and between the 3rd and the 12th month, there was an increment of 23.3 microV and 43.6 microV, respectively. For the upper trapezius, the increase was of 23.1 microV at the third-months evaluation, and 23.3 microV and 43.6 microV between the 3rd and the 12th months. As compared to before the surgery, the evaluation of the middle deltoid muscle did no present significant differences.

CONCLUSIONS

considering muscle activity evaluated by surface electromyography, there was a decrease in the myoelectrical activity of the serratus anterior, due to lesion of the long thoracic nerve (neuropraxia), in the immediate postoperative evaluation. The increase of the mean square root of the electromyographic signal of the upper trapezius muscle, since the preoperative evaluation, suggests a muscular compensation related to the serratus anterior muscle's deficit.

摘要

目的

确定乳腺癌腋窝淋巴结清扫术后肩胛区肌肉的肌电活动模式。

方法

前瞻性队列研究,纳入2006年6月至8月在一家乳腺癌参考中心接受腋窝淋巴结清扫术以治疗乳腺癌的所有女性。在手术前、术后3个月和12个月,通过对前锯肌、上斜方肌和三角肌中部进行体格检查和肌电图检查对这些女性进行评估。

结果

患者的平均年龄为60.3岁(标准差±14.1),体格检查时翼状肩胛的发生率为64.9%。在术后3个月的评估中,观察到前锯肌的肌电活动降低了28.3微伏。在术后12个月的评估以及第3个月至第12个月之间,分别增加了23.3微伏和43.6微伏。对于上斜方肌,在术后3个月的评估中增加了23.1微伏,在第3个月至第12个月之间增加了23.3微伏和43.6微伏。与手术前相比,三角肌中部的评估没有显著差异。

结论

考虑到通过表面肌电图评估的肌肉活动,在术后即刻评估中,由于胸长神经损伤(神经失用),前锯肌的肌电活动降低。自术前评估以来,上斜方肌肌电信号均方根增加,提示与前锯肌功能缺陷相关的肌肉代偿。

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