关键词: 乳腺癌；采血；淋巴水肿；术肢；健肢；随机对照试验；广义估计方程

Abstract: Objective: To explore the effect of different blood collection locations on lymphedema in patients after radical mastectomy. Methods: A total of 219 patients breast cancer who received blood collection at the day reception window of the blood collection center in a tertiary grade A hospital in Chengdu were included. A randomized controlled trial design was used, and the subjects were divided into experimental group of blood collection from the operative limb with 99 participants and the control group of blood collection from the healthy limb with 120 participants. The color Doppler ultrasound was used to measure the internal diameter of the upper limb veins, elbow skin thickness and armpit skin thickness of the operative and healthy limbs 2 hours before blood collection and 1 day after blood collection. The generalized estimating equation model was used to analyze the differences between the two groups of color Doppler ultrasound measurements. Results: There was no statistical difference in other characteristics between the two groups except for vascular conditions (P<0.05). The results of generalized estimating equation showed that there was no significant difference in vein diameter, elbow skin thickness and axillary skin thickness between the two groups (P>0.05). Conclusion: For the patients after radical mastectomy, venous blood collection from the operative limb will not aggravate the upper limb lymphatic swelling, which can be used in clinical practice.

Key words: breast cancer; blood collection; lymphedema; operative limb; healthy limb; randomized controlled trial; generalized estimation equation