[目的] 探讨比较应用“Y”形整复法、“Z”字成形术和摸墙功能锻炼法三种不同方案治疗乳腺癌根治术后并发腋腔瘢痕挛缩的临床效果.[方法] 将2008年3月至2012年11月本院收治的78例乳腺癌术后腋腔瘢痕挛缩患者随机分为三组,A组行腋腔“Y”形整复法, B组采用传统的“Z”字成形术,两组患者术后均佩带外固定支架,使用防治瘢痕增生的药物及早期进行功能锻炼;C组仅采用摸墙法进行功能锻炼.治疗开始后3个月进行疗效判定,疗效评价标准分为治愈、显效、好转和无效四个等级.[结果] A组28例患者中,治愈18例,显效8例,好转2例,治愈率64.29%;B组27例中,治愈12例,显效8例,好转7例,治愈率44.44%;C组23例中,治愈5例,显效9例,好转9例,治愈率21.74%.A组比B组、C组治愈率显著提高,且差异具有显著性(P0.05).[结论] 应用“Y”型整复法治疗乳腺癌术后腋腔瘢痕挛缩疗效优于“Z”字成形术及摸墙功能锻炼法,其能明显改善乳腺癌术后腋腔瘢痕挛缩所致的肩关节活动障碍,临床值得推广.“,”[Objective]To observe the effects of the “Y” reconstructive method, “Z” plasty method, and touching wall exercise method on the treatment of the axillary scar contracture after breast cancer surgery.Movement of the shoulder joint after these three kinds of treatment was observed to evaluate the effectiveness of the treatment.[Methods]Seventy-eight patients in our hospital from March of 2008 to November of 2012 were retrospectively analyzed in this study.The 78 patients were randomly divided into three groups: group A used the “Y” reconstructive method, group B used the “Z” plasty, and group C used the touching-the-wall method.Patients in both group A and B were given the external fixation support after the, drugs to prevent and control scar hyperplasia, and started exercise in the early stages.The patients in Group C only did the touching-the-wall exercise.Three months later, we began to observe and analyze the outcomes.The curative evaluation standards we incorporated can be divided into four grades: cured with an obvious effect, better effect, some effect, and no effects.[Results]Among the 28 patients of Group A, 18 of them were cured with obvious effect, 8 had better effects and 2 of them had some effect-the cure rate was 64.29%.Among the 27 patients of Group B, 12 were cured, 8 had better effects effect and 7 of them had some effect-the overall cure rate was 44.44%.Among the 23 patients of Group C, 5 were cured, 9 had better effects, and 9 had some effect.The cure rate was 21.74%.The statistical analysis showed that the cure rate of group A was significantly higher than group B and group C(P0.05).[Conclusion]The “Y” reconstructive method is superior to both the “Z” plasty and touching-the-wall exercise in treating axillary scar contractures after breast cancer surgery.The “Y” reconstructive method can optimally improve shoulder joint movement which was formerly inhibited by axillary scar contractures.