Российский национальный исследовательский медицинский университет им. Н.И. Пирогова Минздрава России, Москва, Россия
There are a large number of publications confirming the clinical safety of the of physiotherapy application in patients with malignant neoplasms of the breast, but scientific studies on the physical factors complex use in medical rehabilitation of this group of patients in the early postoperative period have not been published yet. Aim. To determine the effectiveness of fluctuating currents in combination with pneumocompression, general magnetotherapy, local magnetotherapy, low-temperature argon plasma applied for patients after radical surgical treatment of breast cancer in the early postoperative period. Material and methods. A prospective, simple, randomized study involving 190 women diagnosed with breast cancer in the early postoperative period after radical Madden mastectomy or radical breast resection (2–4 days) was performed, the average age was 58±10.61 years. The control group consisted of patients included in the course of rehabilitation (exercise therapy, balance therapy and classes with a medical psychologist) fluctuating currents. Low-temperature argon plasma, intermittent pneumocompression, general and local magnetotherapy were added to fluctuations for patients in the main groups. Results and discussion. The analysis of the clinical and functional data showed that in the early postoperative period for breast cancer against the background of the standard drug therapy and the course of medical rehabilitation, the combination of fluctuating currents with intermittent pneumocompression, general and local magnetotherapy significantly reduced the degree of the upper limb edema and the volume of lymphorrhea. The addition of general and local magnetotherapy affects the decrease in the indicators of the shoulder girdle and forearm muscles electrical excitability. Low-temperature argon plasma improves the regeneration of the postoperative suture and reduces swelling and inflammation in this area. The dynamics of the decrease in the level of anxiety and depression, pain syndrome and the general condition of cancer patients are most pronounced in the groups that additionally received magnetotherapy. The volume and quality of movements, muscle strength significantly increased in all groups without differences in results. The action of magnetic fields contributes to the increase of tissue oxygenation, due to which an anti-inflammatory and decongestant effect is realized. Fluctuation of the shoulder girdle and forearm muscles leads to normalization of the functional electrical excitability of the muscles by surgical treatment, which allows to restore the motor stereotype of the limb in a short time, and intermittent pneumocompression affecting the skin and tissue structures of the lower extremities and trunk improves the overall lymph flow, which does not lead to stagnation of lymph in the operated area. Conclusion. Thus, the combined application of physical factors against the background of the standard drug therapy and the course of medical rehabilitation significantly improves the result and recovery time after surgical treatment of the breast cancer in the early postoperative period. A comprehensive approach to medical rehabilitation at the I stage led to the preservation of results in the long-term period 1.5 and 6 months after the operation without adverse events.
medical rehabilitation, low-temperature argon plasma, general magnetotherapy, intermittent pneumocompression, local magnetotherapy, postmastectomy syndrome, breast cancer, early postoperative period, balance therapy, the 1 stage of medical rehabilitation
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