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乳腺癌术后早期手动淋巴引流与运动的比较

Manual lymphatic drainage versus exercise in the early postoperative period for breast cancer.

作者信息

de Oliveira Mariana Maia Freire, de Rezende Laura Ferreira, do Amaral Maria Teresa Pace, Pinto e Silva Marcela Ponzio, Morais Sirlei Siani, Gurgel Maria Salete Costa

机构信息

Physical Therapy Section-Prof. Dr. José Arostodemo Pinotti Women's Hospital-Integral Healthcare Center (CAISM), Universidade Estadual de Campinas (Unicamp) , Campinas , Brazil .

出版信息

Physiother Theory Pract. 2014 Aug;30(6):384-9. doi: 10.3109/09593985.2013.876695. Epub 2014 Jan 10.

Abstract

OBJECTIVE

To compare the effect of active exercise and manual lymphatic drainage (MLD) on postoperative wound healing complications, shoulder range of motion (ROM) and upper limb (UL) perimetry in women undergoing radical mastectomy for breast cancer.

METHODS

Controlled non-randomized clinical trial with 89 women undergoing breast cancer surgery with axillary lymph node dissection (Brazilian Registry of Clinical Trials: 906). Women were matched for staging, age and body mass index, with 46 women allocated to the exercise group and 43 in the MLD group, receiving 2 weekly sessions during one month. Assessments were performed in the preoperative and 60 d after surgery, including inspection, palpation, goniometry and perimetry.

RESULTS

No significant difference existed between groups relative to individual and clinical surgical characteristics. The incidence of seroma, number of punctures performed, dehiscence and infection was similar in both groups. A comparison of shoulder ROM and UL perimetry between groups, obtained in the preoperative and postoperative period, did not show any significant difference.

CONCLUSION

The performance of active exercise or MLD did not demonstrate difference in wound healing complications, shoulder ROM and UL perimetry at 60 d after surgery, suggesting that these techniques may be employed, according to the complaints or symptoms of each woman and physical therapist experience.

摘要

目的

比较主动运动和手法淋巴引流(MLD)对乳腺癌根治性乳房切除术后女性患者伤口愈合并发症、肩关节活动范围(ROM)及上肢(UL)视野检查的影响。

方法

对89例行乳腺癌手术并腋窝淋巴结清扫术的女性进行非随机对照临床试验(巴西临床试验注册:906)。根据分期、年龄和体重指数对女性进行匹配,46名女性被分配到运动组,43名女性被分配到MLD组,在一个月内每周接受2次治疗。在术前及术后60天进行评估,包括检查、触诊、角度测量和视野检查。

结果

两组在个体及临床手术特征方面无显著差异。两组的血清肿发生率、穿刺次数、伤口裂开及感染情况相似。术前及术后两组间肩关节ROM及UL视野检查的比较未显示任何显著差异。

结论

主动运动或MLD在术后60天时在伤口愈合并发症、肩关节ROM及UL视野检查方面未显示出差异,这表明可根据每位女性的主诉或症状以及物理治疗师的经验采用这些技术。

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