ID 113078
Title Alternative
Recovery of patients after minimally invasive surgery for breast cancer (breast-conserving surgery or pectoral muscle-conserving mastectomy) : report 1 : analysis of factors causing delayed recovery of shoulder joint range of motion
乳癌縮小手術患者の肩関節可動域の回復遅延に関わる要因の分析
Author
Kondo, Hiroko The University of Tokushima
Ichihara, Takako The University of Tokushima KAKEN Search Researchers
Miki, Yoshimi National East Tokushima Hospital
Sasa, Mitunori Tokushima Breast Care Clinic
Keywords
乳癌
縮小手術
術後早期
肩関節可動域
回復遅延要因
breast cancer
early postoperative period
shoulder joint range of motion
factors causing delayed recovery
Content Type
Journal Article
Description
本研究は,乳癌で胸筋切除を伴わない縮小手術を受けた患者の肩関節の可動域の回復遅延ケースにおける,回復遅延に関わる要因を明らかにし,術後の機能回復訓練時の患者指導に活かすことを目的とした.対象は乳房温存術や胸筋温存乳房切除術を受けた乳癌術後患者39名で,機能回復訓練を術後12週間縦断的に観察しえたケースにおいて,肩関節可動域の回復状態を良好群と遅延群の2群にわけ,その2群間の比較を,肩関節可動域や疼痛・日常生活動作から観察した.その結果,遅延群ケースから肩関節可動域の回復に関わる主要因として,創部の動作時の疼痛が考えられ,2つめの要因としてこの動作時の疼痛の発生により術後必要とされる運動を行わないことで,さらに回復を遅延させていることが考えられた.よって,動作時の疼痛を訴え,肩関節可動域の回復の遅れを認める例には,機能回復訓練状態の観察と術後12週目までの継続的な運動の必要性の指導のほかに,肩関節可動域訓練を看護師が患者とともに一緒に行うという確実な実施が,肩関節の可動域の回復遅延の予防となると考えられた.
Description Alternative
The present study was undertaken to identify factors responsible for delay in recovery of the shoulder joint ROM (range of motion) after minimally invasive surgery for breast cancer (i.e., surgery not involving pectoral muscle excision), with the goal of facilitating better postoperative rehabilitation. The subjects of this study were 39 patients who were followed during 12 weeks of functional rehabilitation after breast-conserving surgery or pectoral muscle-conserving surgery for breast cancer. They were divided into the good recovery group and the delayed recovery group according to the smoothness in recovery of shoulder joint ROM. Shoulder joint ROM, pain and activity of daily living (ADL) were compared between these two groups. Analysis of the data from the delayed recovery group allowed us to identify the pain during movement of the surgical wound as a leading factor affecting the recovery of shoulder joint ROM. Failure to practice exercise after surgery due to pain during motion of the wound was identified as the second leading cause for delayed recovery. These results suggest that in cases where postoperative recovery in should joint ROM is delayed, recovery may be facilitated by monitoring the progress of rehabilitation, advising the patient to continue exercise until day 12 after surgery and guiding the patient to practice shoulder joint ROM training with the help of the nurse.
Journal Title
The Journal of Nursing Investigation
ISSN
13483722
24342238
NCID
AA11937122
Publisher
徳島大学医学部
Volume
1
Issue
1
Start Page
19
End Page
25
Sort Key
19
Published Date
2003-03-31
EDB ID
FullText File
language
jpn
TextVersion
Publisher
departments
Medical Sciences