染料法腋窝反向淋巴作图与前哨淋巴结活检在乳腺癌术中应用研究  

Application of axillary lymph reversing dye method and display of sentinel lymph node in breast cancer

作　　者：钱立宇[1] 钱军[1] 李德群[1] 王亚国[1] 喻大军[1] 李靖[1] 张立功[1] 

机构地区：[1]蚌埠医学院第一附属医院肿瘤外科三病区,安徽蚌埠233000

出　　处：《中国实用外科杂志》2015年第2期208-210,共3页Chinese Journal of Practical Surgery

摘　　要：目的 研究染料法腋窝反向淋巴作图（axillary reverse mapping,ARM）结合前哨淋巴结活检（sentinel lymph nodebiopsy,SLNB）在乳腺癌术中的应用。方法 回顾性分析2011年6月至2013年6月蚌埠医学院第一附属医院肿瘤外三科收治的共363例乳腺癌病人资料,均行乳腺癌腋窝淋巴结清扫术（ALND）,其中联合行ARM＋SLNB者78例（ARM＋SLNB组）,单纯行ALND者285例（ALND组）,比较两组术后疗效。结果 ALND组病人术后带管时间为（12.3±1.5）d,而ARM＋SLNB组为（9.6±1.9）d,二者差异有统计学意义（t=11.74,P〈0.05）。ARM＋SLNB组术后第1-7天的引流量均较ALND组明显减少,差异有统计学意义（P〈0.05）。随访12个月,两组均未发现Ⅲ级水肿,第12个月ALND组与ARM＋SLNB组水肿发生率差异有统计学意义（P〈0.05）。结论 ARM可保护患侧上肢淋巴通道,减少术后上肢水肿的发生。Objective To study the way of axillary reverse mapping （ARM） combined with sentinel lymph node biopsy（SLNB） in application of breast cancer surgery. Methods The clinical data of 363 cases of breast cancer perfonedaxillary lymph nodes dissection （ALND） between June 2011 and June 2013 in the First Affiliated Hospital of BengbuMedical College were analyzed retrospectively. The therapeutic effects between ARM ＋ SLNB group （78 cases） andALND alone group （285 cases） were compared. Result Postoperative time with tube in ALND group was （12.3 ± 1.5） d,and ARM ＋ SLNB group was （9.6± 1.9） d. The difference was significant statistically （t =11.74, P〈0.05）. Drainage ofpostoperative 1 to 7 days in ARM＋SLNB group was reduced significantly compared with ALND group, and the differencewas significant statistically （P〈0.05）. For the follow-up of 12 months, there was no edema of grade HI in the two groups.Moreover, incidences of edema in the first 12 months between ALND group and ARM ＋ SLNB group were differentsignificantly （P〈0.05）. Conclusion ARM can protect the upper limb lymph channels and reduce postoperative upperextremity edema.

关 键 词：腋窝反向作图 前哨淋巴结 乳腺癌 上肢淋巴水肿 

分 类 号：R6[医药卫生—外科学]