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乳房切除术后淋巴水肿患者腋窝静脉的超声变化

Ultrasonografic changes in the axillary vein of patients with lymphedema after mastectomy.

作者信息

de Abreu Junior Gilberto Ferreira, Pitta Guilherme Benjamin Brandão, Araújo Marcelo, Castro Aldemar de Araújo, de Azevedo Junior Walter Ferreira, Miranda Junior Fausto

机构信息

Escola Bahiana de Medicina e Saúde Pública, Salvador, BA, Brazil.

Universidade Estadual de Ciências da Saúde de Alagoas, AL, Brazil.

出版信息

Rev Col Bras Cir. 2015 Mar-Apr;42(2):81-92. doi: 10.1590/0100-69912015002004.

Abstract

OBJECTIVE

To determine the prevalence of sonographic abnormalities (SA) in the axillary vein of patients with and without post-mastectomy lymphedema.

METHODS

We studied a sample of 80 women, divided into two equal groups, with and without lymphedema, with B mode ultrasound, color and pulsed Doppler. The primary variable, SA, is defined as change in the venous diameter, parietal thickening, intraluminal images, compressibility, parietal collapse at inspiration and feature of the axillary venous flow on the operated side. Secondary variables were: stage of lymphedema, surgical technique, number of radio and chemotherapy sessions, limb volume, weight and age. The differences between the proportions in the groups were determined using the Chi-square test and / or Fisher's test. For continuous variables, we used the Mann-Whitney Test. To estimate the magnitude of the associations, we used the prevalence rate of SA in both groups as a measure of frequency, and as a measure of association, the prevalence ratio (PR) obtained as a function of relative risk (RR) and estimated by the test Mantel-Haenszel homogeneity test. We adopted the statistical significance level of 5% (p < 0.05).

RESULTS

only the criterion "parietal thickening" was strongly associated with the lymphedema group (p = 0.001). The prevalence of SA was 55% in patients with lymphedema and 17.5% in the group without it, with difference in prevalence of 37.5%.

CONCLUSION

the prevalence of SA was higher in patients undergoing mastectomy with lymphedema than in those without lymphedema.

摘要

目的

确定有或无乳房切除术后淋巴水肿患者腋窝静脉超声异常(SA)的患病率。

方法

我们对80名女性进行了研究,将其分为两组,每组40人,分别为有淋巴水肿组和无淋巴水肿组,采用B型超声、彩色和脉冲多普勒进行检查。主要变量SA定义为手术侧静脉直径变化、壁增厚、腔内图像、可压缩性、吸气时壁塌陷以及腋窝静脉血流特征。次要变量包括:淋巴水肿分期、手术技术、放疗和化疗疗程数、肢体体积、体重和年龄。使用卡方检验和/或费舍尔检验确定两组比例之间的差异。对于连续变量,我们使用曼-惠特尼检验。为了估计关联程度,我们将两组中SA的患病率作为频率度量,将患病率比(PR)作为关联度量,PR通过相对风险(RR)函数获得,并通过曼特尔-亨泽尔同质性检验进行估计。我们采用5%(p < 0.05)的统计显著性水平。

结果

仅“壁增厚”这一标准与淋巴水肿组密切相关(p = 0.001)。淋巴水肿患者中SA的患病率为55%,无淋巴水肿组为17.5%,患病率差异为37.5%。

结论

有淋巴水肿的乳房切除患者中SA的患病率高于无淋巴水肿的患者。

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