| ObjectiveIn this study,enhanced recovery after surgery(ERAS)was performed on patients after modified radical resection of breast cancer by guiding patients to carry out functional exercise,to explore the influence of early shoulder function exercise on the function recovery and quality of life of the affected limb,and to provide a scientific basis for early shoulder function exercise intervention and to promote the recovery of postoperative symptoms for patients with breast cancer.MethodsA total of 206 patients with breast cancer treated with modified breast surgery in the Breast Surgery Department of the Second Clinical Medical College of Qingdao University(Qingdao Central Hospital)from February 2018 to August 2019 were included in this study.The included cases were assigned to control groups(n=103)and intervention groups(n=103)by ward structure.Cases in the control group were performed routine perioperative care especially on the affected upper limbs and shoulders in about 1 week after surgery;The intervention group received ERAS nursing mode.SPSS 19.0 statistical software was used for statistical processing,and the upper limb function recovery and the impact on quality of life of the two groups were compared,including the upper limb function indicators: upper arm abduction,forward extension,backward extension,finger climbing height;Upper limb edema evaluation indexes: shoulder diameter(10cm below acromion),upper arm circumference diameter(5cm above the elbow stripe)and forearm circumference diameter(10cm above the wrist stripe)were measured.Drainage flow in operative area;complication rate,average length of stay;Quality of life indicators: Breast cancer Quality of Life Scale(FACT-B),comfort scale(GCQ).Results1 Comparison of upper limb function evaluation indexes between the two groups(1)Comparison of functional recovery degree of the affected side of the upper limb between the two groups after surgery: there were statistically significant differences between the intervention group and the control group in the abduction,extension and extension of the affected side of the upper limb at 2w and 4w after surgery,as well as in the height of finger climbing the wall on the affected side of the patient(P <0.05).(2)Comparison of upper limb edema evaluation indexes between the two groups:compared with the control group,the incidence of upper limb edema on the affected side of the intervention group was significantly different at 2w(=4.348,P<0.05)and 4w(=5.107,P<0.05)after surgery.(3)Comparison of surgical drainage between the two groups: Compared with the comparison of surgical drainage between the two groups,the drainage in the intervention group was significantly less than that in the control group(control group:515.57±103.29,intervention group:495.04±97.58),and the difference was not statistically significant(t=1.445,P>0.05).2 Comparison of complications and hospitalization days between the two groupsThe incidence of complications in the intervention group compared with the control group(P>0.05),and there was no statistical significance.Length of stay in the intervention group compared with the control group(t=7.432,P<0.05),which was statistically significant.3 Comparison of quality of life indicators(1)Comparison of dimensions of fact-B for breast cancer patients: The physiological status of the intervention group compared with the control group(t=3.858,P<0.001),social/family status(t=1.216,P>0.05),emotional status(t=3.463,P<0.001),functional status(t=12.128,P<0.001),additional attention(t=6.207,P<0.001)and total scores(t=10.578,P<0.001),social/family status had no statistical significance,while other indicators had statistical significance.(2)Comparison of various dimensions of GCQ: The physiological comfort scores of the intervention group compared with the control group(t=10.644,P<0.001),psychological comfort scores(t=4.257,P<0.001),sociocultural comfort score(t=2.359,P<0.05),environmental comfort score(t=2.320,P<0.05),the difference was statistically significant.ConclusionsFor breast cancer patients with modified radical accelerate rehabilitation surgery concept to guide function exercise,early shoulder joint activity intervention can effectively promote the recovery of upper extremities function,reduce edema,without increasing the area traffic,shorten the hospitalization days,the area did not cause patient injury and increased risk of postoperative complications associated with good security;At the same time,early shoulder functional exercise based on ERAS concept can play a positive role in improving patients’ quality of life and comfort,and provide reference for the recovery of affected limb function and improvement of life quality of patients after breast cancer surgery. |
