目的 根治(或改良根治)乳房切除手术后理疗可以减轻患者皮下积液、血肿,患侧肩功能活动障碍,但是术后何时进行患侧肩关节功能锻炼还存在争议.本文针对1例乳腺癌患者,检索当前最佳证据并进行评价,为临床合理治疗提供依据.方法 计算机检索Cochrane图书馆、Medline、EMbase、中国生物医学文献数据库(CBMdisc)、中国期刊全文数据库(CJFD)、中文科技期刊数据库(VIP)的随机对照试验(randomized controlled trials RCT)和Meta分析,检索时间从数据库建立至2008年5月.检索词包括"breast neoplasm," "breast cancer," "breast carcinoma," "mastectomy," "modified radical mastectomy," "radical mastectomy," "shoulder function," "seromas," "shoulder exercises," combined with "randomized controlled trials," "randomized controlled trial," "random allocation," "乳腺癌、乳腺肿瘤、乳癌、手术、根治手术、改良手术、肩功能、肩关节锻炼、随机".对所获得的证据按照循证医学评价证据的原则进行质量评价.结果 共筛选出3篇RCT.检索出的证据表明,对于行根治(或改良根治)乳房切除手术的患者,术后开始何时开始理疗只影响创面液体引流量,而与患侧肩关节的功能恢复无关.该患者手术后9d开始理疗,术后恢复顺利,术

作者：卞正霞；杨青；杨孙虎

来源：中国全科医学 2010 年 13卷 z1期