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目的:观察左侧胸部放疗对乳腺癌保乳术患者的心功能及生活质量的影响。方法:连续选择新近接受乳腺癌保乳手术并进行了左侧胸部放射治疗的患者35例(放疗组),于放射治疗前、后接受了常规超声心动图(ECG)及组织多普勒(TDI)检测以及“中国心血管病人生活质量评定问卷(CQQC)”评估,并与31例同期接受乳腺癌根治术,且未接受胸部放疗患者(对照组)的检查结果进行比较。结果:两组对象放射治疗前ECG、TDI检查的左心功能指标,和CQQC量表各维度评分及CQQC总分无显著差异(P均>0.05)。5周治疗后,与治疗前及对照组治疗后比较,放疗组的E[(0.90±0.32)cm/s比(0.90±0.38)cm/s比(0.86±0.29)(cm/s],E/A[(1.28±0.46)比(1.28±0.45)比(1.20±0.38)],及Em[(10.12±1.93)cm/s比(9.95±1.64)cm/s比(7.51±1.12)cm/s],Em/Am[(1.25±0.26)比(1.24±0.23)比(0.90+0.15)]显著降低(P均<0.05);同时CQQC量表所有维度评分(P<0.05~<0.01)及CQQC总分[(67.36±7.87)分比(63.75±7.26)分比(52,83±6.40)分](P<0.01)也明显减少。结论:接受左侧胸部放疗的乳腺癌保乳术患者常有左心功能及生活质量下降,应进行有针对性的康复治疗。
Objective: To observe the effect of left chest radiotherapy on cardiac function and quality of life in breast conserving surgery. Methods: Thirty-five patients (radiotherapy group) who underwent conservative breast-conserving surgery and received left chest radiotherapy were enrolled in this study. Before and after radiotherapy, patients underwent routine echocardiography (ECG) and tissue Doppler imaging ) And the “Quality of Life Questionnaire for Chinese Patients with Cardiovascular Disease” (CQQC) were evaluated and compared with the results of 31 patients who underwent radical mastectomy for breast cancer without chest radiotherapy (control group). Results: There was no significant difference between the two groups in the left heart function index of ECG and TDI before radiotherapy and the CQQC scores and the CQQC scores (all P> 0.05). After 5 weeks of treatment, E (0.90 ± 0.32) cm / s (0.90 ± 0.38) cm / s (0.86 ± 0.29) cm / s and E /A[(1.28 ± 0.46) (1.28 ± 0.45) vs (1.20 ± 0.38)] and Em [(10.12 ± 1.93) cm / s vs (9.95 ± 1.64) cm / s vs (P <0.05 ~ <0.01), and the scores of all dimensions of CQQC scale (P <0.05 ~ <0.01) and the ratio of Em / Am [1.25 ± 0.26 vs 1.24 ± 0.23 (0.90 ± 0.15) The score of CQQC [(67.36 ± 7.87), (63.75 ± 7.26), 52.83 ± 6.40] (P <0.01) also decreased significantly.Conclusion: Breast conserving surgery patients undergoing left chest radiotherapy Often left heart function and quality of life decline, should be targeted rehabilitation.