| Objective:To explore the related influencing factors of postoperative subcutaneous effusion and upper limb edema in breast cancer patients,and explore the effective ways to reduce the occurrence of subcutaneous effusion and upper limb edema,so as to provide inspiration and help for reducing the incidence of subcutaneous effusion and upper limb edema in clinical practice.Materials and Methods:A total of 220 continuous cases of breast cancer in the department of breast surgery of the first affiliated hospital of Zheng Zhou university from October 2014 to October 2017 were collected.According to the patient will subcutaneous effusion and upper limb edema after surgery patients can be divided into the following four groups:study group Ⅰ(breast cancer patients with severe postoperative subcutaneous effusion and upper extremity edema),the research group Ⅱ(with severe postoperative subcutaneous effusion)in patients with breast cancer in postoperative subcutaneous effusion,research group Ⅲ(breast cancer occur in patients with upper limb edema after operation),the research group Ⅳ(breast cancer does not appear after subcutaneous effusion and upper limb edema patients);The specific research projects are as follows:basic data analysis of patients in each group:analysis of age,height,weight,combined medical history(hypertension,diabetes,coronary heart disease,hypoproteinemia,etc.);Surgical methods,different incision designs,different choices of ultrasonic and electric scalpel,different intraoperative treatment of latissimus dorsi muscle,blood loss,lymphatic dissection methods,radiotherapy or not,and daily subcutaneous drainage volume one week after the operation were analyzed.Single factor and Logistic multiple factor analysis of various factors to provide help for prognosis and nursing.Results:In the number of patients,coronary heart disease,hypoalbuminemia,postoperative way(modified radical,radical prostatectomy)and so on in the project analysis,combined with subcutaneous effusion and upper limbs swelling ratio the most,the most serious,pure with subcutaneous effusion times,moreover is pure upper limb swelling in patients,patients with subcutaneous effusion and upper limb swelling,is the end,comparison between groups in the trend for the group Ⅳ<group Ⅲ<group Ⅱ<group I,P<0.05,the difference is statistically significant;Flow analysis:during the 24-hour analysis of drainage volume,the trend of each group was compared as study Ⅳ group<study Ⅲ group<study Ⅱ group<study I group,and the data between each group was compared(P<0.05),with statistically significant differences.The data analysis 7 days after the operation showed the same regularity,and the data comparison between each group was P<0.05,the difference was statistically significant.In the analysis of drainage volume at 24 hours and 7 days after surgery,the data of each group were 0.022,0.045,0.060 and 0.079,and the data of patients with subcutaneous effusion and upper limb swelling and patients with simple subcutaneous effusion were compared,P<0.05,which was statistically significant.Comparison of flow trend:the drainage volume of subcutaneous effusion in patients with subcutaneous effusion and upper limb swelling reached the peak on the first day,and gradually decreased with the increase of the number of days.The patients in the subcutaneous effusion group also showed the same trend,but the overall drainage volume was less than that in the group with subcutaneous effusion and upper limb swelling.The data of the two groups were compared,P<0.05,with statistically significant difference.Single factor analysis:age,body mass index,hypertension,diabetes,neoadjuvant chemotherapy and surgery time is lead to breast cancer patients of postoperative subcutaneous disease and merge upper limb swelling in risk factors,the comparison between groups for the study of the Ⅳgroup<III group<group Ⅱ<group Ⅰ P values were 0.049,0.020,0.048,0.049,0.045,0.002,P<0.05,the difference is statistically significant;Multi-factor analysis:each group patients’ age,body mass index,a new auxiliary means,metastasis lymph node number and size of the subcutaneous efusion of breast cancer is a risk factor for postoperative subcutaneous effusion and upper limb edema,the comparison between each group as the study group Ⅳ<group Ⅲ<group Ⅱ<group I,P values were 0.020,0.034,0.034,0.021 and 0.004,are less than 0.05,the difference is statistically significant;Single factor analysis:the statistical P values of age,neoadjuvant chemotherapy,number of metastatic lymph nodes,subcutaneous fluid flow and tumor size in each group were 0.027,0.045,0.049,0.012 and 0.044,respectively,which were all smaller than 0.05,and the differences were statistically significant In multivariate analysis,the statistical P values of age,neoadjuvant chemotherapy,number of metastatic lymph nodes,subcutaneous effusion flow and tumor size in each group were 0.045,0.039,0.034,0.023 and 0.039,respectively,which were all smaller than 0.05,and the differences were statistically significant.Recurrence free survival:in the single-factor analysis,the statistical P values of age,neoadjuvant chemotherapy,number of metastatic lymph nodes,subcutaneous fluid flow and tumor size in each group were 0.027,0.045,0.049,0.012 and 0.044,respectively,which were all smaller than 0.05,and the differences were statistically significant.In the multivariate analysis,the statistical P values of age,neoadjuvant chemotherapy,number of metastatic lymph nodes,subcutaneous effusion flow and tumor size in each group were 0.045,0.039,0.034,0.023 and 0.039,respectively,which were all smaller than 0.05,and the differences were statistically significant.Conclusions:(1)The occurrence of subcutaneous effusion and upper limb swelling in breast cancer patients is associated with many factors,among which,Patients with the combination of the two accounts for a relatively high proportion in terms of average age,body mass index,basic diseases,proportion of adjuvant chemotherapy,number of lymphatic resection and tumor size,followed by patients with simple subcutaneous effusion,and patients with simple upper limb swelling,both of which have no patients.Finally,some clinical references are given.(2)The drainage volume of breast cancer patients accompanied by subcutaneous effusion and upper limb swelling within one week after surgery was clear significantly increased.Upper limb swelling can promote the severity of subcutaneous effusion in patients and increase their drainage volume.With the extension of time,the drainage volume gradually decreases.(3)The patient’s age,body mass index,hypertension,diabetes,neoadjuvant chemotherapy and operation time were risk factors for postoperative subcutaneous effusion and upper limb swelling in breast cancer patients.The older the patient is,the greater the bmi is,the more likely the subcutaneous effusion and upper limb swelling in breast cancer patients.(4)Univariate and multivariate analysis showed that age,neoadjuvant chemotherapy,number of metastatic lymph nodes,subcutaneous effusion flow and tumor size were all independent predictors of the overall survival and recurrence of breast cancer patients after surgery,which had certain clinical significance. |
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