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| 題 名 | Abnormality of Shoulder Motions in Postmastectomy Patients=乳癌切除手術後病人之肩關節活動異常 |
|---|---|
| 作 者 | 黃麗麗; | 書刊名 | 物理治療學會雜誌 |
| 卷 期 | 11 1986.11[民75.11] |
| 頁 次 | 頁72-79 |
| 分類號 | 418.92 |
| 關鍵詞 | 乳癌切除手術病人; 肩關節活動異; |
| 語 文 | 英文(English) |
| 中文摘要 | 國立臺淺大學醫學院附設醫院之乳房切除手術後乳癌病人之聯誼會于 民國花年年初成立;從三月開始,聯誼會每個月有一次活動。為研究乳癌病人在 接受乳房切除手術後之肩關節活動度,包括異常之程度,發生率與特性;並為尋 求引起肩關節活動度異常的可能原因,提供未來乳房切除手術後病人復健計劃之 參考。著者等在三月到五月之曰次聯誼會活動中,共檢查了101例單側乳房切除 病人之肩關節活動度。在這些病人中,有9'位病人接受改良性乳房切除術 (modifiedradicalmasteCtOmy),11位病人在開刀後曾接受放射線治療 (radio-therapy)。全部病例傷口癒合所需的平均日.數為22.5±19.6天。 總共有70的病人在乳癌同側肩關節(患側)有關節活動度減小的現象。患側肩關節 活動度減小的發生率很明顯地高於健側(P<0.01)。無論是肩前屈(flexion.)、外展 (ab-duction),或內外轉(internaland.externa@ rotation),活動的範圍皆比健側明顯 地減少(P<0.01)。其受限制之程度與發生率並不相同;有72位病人肩前屈無法到達 正常的角度(180°),但其所受限制卻很輕微,而肩內外轉的活動度,有減小的病 人雖不多,但都較為嚴重,分別有1/3及1/2的病人喪失1/3以上的關節活動度。 引起肩關節活動受限的因素很多,因為缺乏適當的指導,病人為使傷口癒合,固 定(immobilization)患側過久,應是活動受限主因之一。此外,傷口癒合時間長短 及手術後是否曾接受放射線治療也和肩關節活動異常狀況有關。因此,作者建議 應為乳房手術後病人建立一套有系統的復健計劃,以幫助病人手術後的復原。在 本研究中,病人的年紀、患側之位置及手術後之活動量與肩關節活動度的受限並 無明顯相關。 |
| 英文摘要 | The range of shoulder motions of 107 postmastectomy patients were evaluated by physicaltherapists during the monthly activities of the Breast Cancer Club, National Taiwan UniversityHospital in Mar., Apr., and May, 1986. Among them, 12 patients received radical mastectomy,and the 95 patients the modified radical mastectomy (MRM), while 17 patients received postoperative radiotherapy. The mean duration of wound healing of all patients was 22.5 ± 19.6days. Seventy percent of the patients had limited range in one or more directions of motion of is pilateral shoulders (affected side) after mastectomies. The incidence of abnormal ROM of the affected shoulder was significantly higher than that of the sound shoulders. The range of motions including flexion, abduction, external and internal rotation of the affected shouldersdecreased significantly (p < 0.01) than those of the sound sides of the patients. The mean ROM of them were 159.9°, 151.6°, 77.4° and 81.0° respectively, The incidence and severity of limited motions of the affected shoulders were different.Although 72 patients got limitation in shoulder flexion, the limitations were quite mild.Shoulder external and internal rotation showed least but most severely affected. Proinged immobilization was considered to tie the cause of limited mobility of affectedshoulder of 'patients. Duration of wound healing and postoperative radiotherapy were alsocorrelated with the decreased ROM of affected shoulders of patients. Other possible correlatedfactors such as age of patients, side of operation, postoperative activities did not show anysignificant relations with the limited motions of the affected shoulders of patients in thisstudy. A comprehensive rehabilitation program for breast cancer patients should be set up tohelp the patients from the development of shoulder contractures. |
本系統中英文摘要資訊取自各篇刊載內容。