乳がん術後患者のリンパ浮腫重症度と末梢皮膚血流量の関連—基礎的研究

Relation between Lymph Edema Severity of Symptoms and Peripheral Skin Blood Flow Volume after the Breast Cancer Operation: Fundamental Study

要旨

　本研究は，末梢皮膚血流量が乳がん術後のリンパ浮腫重症度を予測しうるか，その指標的有効性を検討することを目的に実施した．女性乳がん患者61名と健康な女性35名を被験者として，血流計を用いた末梢皮膚血流量測定を実施し，リンパ浮腫の有無と重症度で検討した．その結果，リンパ浮腫患者の血流量は健康な女性よりも少なく，右乳がん患者においては，浮腫患者が非浮腫患者より少なく，左乳がん患者では浮腫患者は非浮腫患者より多い血流量を示した．また，浮腫の重症度が増すとともに左右の血流量差が大きくなり，浮腫中等症患者における左右の血流量差は，左乳がん患者が右乳がん患者の2倍の値を示すことが確認された．これらの結果から，左右の血流量差がリンパ浮腫の重症度を判断するうえで，指標の一つとなる可能性とともに，異なる血流量差を認めたことから，手術側別に観察基準の作成および介入方法を変える必要があることが示唆された．

Abstract

　The purpose of this study was to examine the index efficacy of the peripheral skin blood flow volume by determining whether it could be used to predict the severity of lymphedema. The subjects of this study were 61 female breast cancer patients and 35 healthy females. The peripheral skin blood flow volume was measured by using the rheometer. The measurements were examined along with the existence of lymphedema and its severity. The results showed that the blood flow volume of the patients was significantly less than that of the healthy females. Among the right breast cancer patients, the blood flow volume of those with lymphedema was less than that of those without. Among the left breast cancer patients, the blood flow volume of those with lymphedema was more than that of those without. It was also shown that as the severity of lymphedema increased, so did the difference of the volumes between the left and right sides. Among the patients with the middle level severity, the flow volume of the left breast cancer patients was double that of the right-breast cancer patients. The results indicated a possibility of using the difference of blood flow volumes between the left and right sides, as an index for judging the severity of lymphatic anasacrca. It was also implied that the formation of the observational criterion and the intervention method which take into consideration the differences of blood flow volume, need be modified between left and right breast cancer patients.