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固定、淋巴水肿和肥胖是乳腺癌患者粘连性肩关节囊炎发展的预测因素。

Immobilization, Lymphedema, and Obesity are Predictive Factors in the Development of Adhesive Capsulitis in Breast Cancer Patients.

机构信息

Universidade Federal de Goiás, Goiânia, GO, Brazil.

出版信息

Rev Bras Ginecol Obstet. 2023 Oct;45(10):e594-e602. doi: 10.1055/s-0043-1772479. Epub 2023 Nov 9.

Abstract

OBJECTIVE

Adhesive capsulitis is a condition characterized by shoulder pain and stiffness. Breast cancer treatment has been linked to the development of this condition, but its mechanisms are still little known. This study's objective was to identify predictors factors associated with the development of adhesive capsulitis in breast cancer patients.

METHODS

A case control study was performed with women undergoing treatment for breast cancer in a single center. The sampling was nonprobabilistic and consecutive. Adhesive capsulitis was defined as constant pain associated with decreased active and passive shoulder movement in anterior elevation, external rotation at 0°/90° abduction, and internal rotation at 90° abduction. The study group consisted of patients with shoulder pain and range of motion limitations, while the control group consisted of women without any shoulder abnormalities. Sociodemographic and clinical variables were collected. A univariate logistic regression was used to assess the influence of variables on the studied outcome. For  < 0.20, a multivariate logistic regression was used. The probability of null hypothesis rejection was 5%.

RESULTS

A total of 145 women were assessed, with 39 (26.9%) on the study group and 106 (73.1%) on the control group. The majority was under 60 years old. In the multivariate analysis, variables correlated to the outcome under study were shoulder immobilization (OR = 3.09; 95% CI: 1.33-7.18;  = 0.009), lymphedema (OR = 5.09; 95% CI: 1.81-14.35;  = 0.002), and obesity (OR = 3.91; 95% CI: 1.27-12.01;  = 0.017).

CONCLUSION

Lymphedema, postsurgery immobilization, and obesity are predictive factors for the development of adhesive capsulitis in breast cancer patients.

摘要

目的

粘连性肩关节囊炎是一种以肩部疼痛和僵硬为特征的疾病。乳腺癌的治疗与这种疾病的发生有关,但发病机制仍知之甚少。本研究的目的是确定与乳腺癌患者粘连性肩关节囊炎发展相关的预测因素。

方法

对在一家中心接受乳腺癌治疗的女性进行了病例对照研究。抽样是非概率的连续抽样。粘连性肩关节囊炎的定义为在肩部前抬高、外展 0°/90°时的主动和被动肩部运动受限、伴有恒定疼痛,以及内旋时外展 90°。研究组由肩部疼痛和活动范围受限的患者组成,对照组由无任何肩部异常的女性组成。收集了社会人口统计学和临床变量。采用单变量逻辑回归评估变量对研究结果的影响。对于<0.20 的变量,采用多变量逻辑回归。拒绝零假设的概率为 5%。

结果

共评估了 145 名女性,其中 39 名(26.9%)在研究组,106 名(73.1%)在对照组。大多数患者年龄在 60 岁以下。在多变量分析中,与研究结果相关的变量是肩部固定(OR=3.09;95%CI:1.33-7.18;P=0.009)、淋巴水肿(OR=5.09;95%CI:1.81-14.35;P=0.002)和肥胖(OR=3.91;95%CI:1.27-12.01;P=0.017)。

结论

淋巴水肿、手术后固定和肥胖是乳腺癌患者发生粘连性肩关节囊炎的预测因素。

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