关键词: 乳腺肿瘤, 手术后并发症, 功能锻炼, 循证医学

Abstract: Objective　To summarize and evaluate the best evidence of early postoperative functional exercise in breast cancer patients.Methods　In June 2017，clinical practice guidelines，systematic reviews and related evidence-based resources pertaining to early postoperative functional exercise in breast cancer were retrieved through the Chinese databases，English databases and guideline websites by computer.The publication-data limit was set by May 2017.The literatures screened were read and the literature quality was assessed by two investigators.All data needed were extracted from the literatures that met the quality.Results　Nineteen articles were enrolled，including three clinical practice guidelines，nine systematic reviews，and seven related evidence-based resources.The three clinical practice guidelines mainly included principles of functional exercises，forms of instruction，the content of functional exercises，standard requirements and considerations.The 16 systematic reviews and related evidence-based resources mainly included principles of functional exercises，forms of instruction，functions of educators，the content of exercise，effect evaluation of exercise，parameters of exercise and the evaluating indicator.It was suggested that professionals should follow the principle of gradual progress，combined with paper-based materials to guide patients.Preoperative assessment of bilateral upper extremity function should be performed.1-2 days after the operation，the shoulder joint should remain motionless，and activities of fingers，wrists and elbow joints be performed.The time of shoulder joint activity is controversial，so professionals should weigh the pros and cons，according to the patients' situation （such as drainage，wound healing，or subcutaneous effusion） to guide patients with shoulder joint activity at their discretion.If the patient has the factors that affect wound healing and drainage，one week of functional exercise can be delayed （9-10 days after the operation）．Conclusion　Evidence-based exercise instruction projects have not been found so far in China.Investigators should propose evidence-based guidelines based on the latest best evidence of early functional exercise，clinical context of care，the patient's needs and preferences and professional judgment.

Key words: Breast neoplasms, Postoperative complications, Exercise, Evidence-based medicine