早期乳腺癌56例保乳手术临床疗效观察  

Study on effect of breast-conserving surgery and modified radical mastectomy in treatment of patients with early breast cancer

作　　者：向茜[1] 唐卫[2] 

机构地区：[1]湖南省怀化医专附属怀化市第三人民医院普外二科,湖南怀化418000 [2]湖南省肿瘤医院乳腺外科,湖南长沙410000

出　　处：《临床和实验医学杂志》2013年第20期1664-1666,共3页Journal of Clinical and Experimental Medicine

摘　　要：目的 探讨早期乳腺癌保留乳房手术治疗的效果.方法 将符合保乳手术的120例按随机及患者意愿原则分为保乳手术组及改良根治手术组,手术后两组患者均实施术后辅助化疗及放疗,对雌激素受体、孕激素受体阳性者行内分泌治疗.术后随访24～84个月.比较两组围手术期指标,并发症的差异,比较两组患者乳房外形及患者满意度;比较术后两年间两组焦虑自评量表和抑郁自评量表差异;同时比较两组患者的远期疗效.结果 ①保乳手术组手术时间、术中平均出血量、术后平均引流量及住院天数均优于改良根治术组（P＜0.05）;②两组皮下积液、皮瓣坏死、上肢水肿、后遗患侧上肢功能障碍及后遗神经痛等并发症差异无统计学意义（P＞0.05）;③两组局部复发率、远处转移率及5年总生存率比较无统计学差异（P＞0.05）;④保乳组的乳房外形美容明显优于改良根治术组（P＜0.05）,保乳组对其乳房外形满意度明显高于改良根治术组（P＜0.05）,保乳组患者在焦虑或抑郁等负性情感方面明显弱于改良根治手术组（P＜0.05）.结论 早期乳腺癌保留乳房手术治疗效果好,可明显改善患者术后生存质量,值得推广应用.Objective To explore the effect of breast conserving surgery and modified radical mastectomy in treatment of patients with early breast cancer. Methods A total of 120 patients with early breast cancer in this hospital were randomly divided into two groups： breast con serving surgery group and modified radical mastectomy group. All patients in both groups accepted postoperative adjuvant chemotherapy and radiotherapy, and those patients with positive ER and PR were given with endocrine therapy. All patients were followed up for 24 to 84 months. Perioperative indicators, complications, appearance of breast, satisfaction of patients, difference in SAS and SDS at 2 years after operation and long term efficacy of these two groups were compared. Results There was significant difference in operating time, mean volume of intra operative bleeding, mean duration of postoperative drainage and hospitalization days, and these indicators in breast conserving surgery group were better than those of modified radical surgery group（ P 〈 0.05 ）. There was no significant difference in collection of subcutaneous fluid, necrosis of skin flap, edema in upper extremity, upper limb dysfunction and postoperative neuralgia between these two groups （ P 〉 0.05 ）. The differ ence in local recurrence rate, distant metastasis rate and 5 year survival rate between these two groups was not significant （ P 〉 0. 05 ）. The appearance of breast and satisfaction of patients in breast conserving group were superior to those of modified radical surgery group （ P 〈 0.05 ）. The negative affection of anxiety and depression were significantly weaker than those of modified radical surgery group （ P 〈 0. 05 ）. Conclusion The effect of breast conserving surgery in treatment of patients with early breast cancer is satisfactory. It can significantly improve the life quality of patients, hence it is worthy to be recommended for wide application.

关 键 词：早期乳腺癌 保乳手术 乳腺癌改良根治术 

分 类 号：R737.9[医药卫生—肿瘤]