保乳手术与改良手术在乳腺癌治疗中的效果比较  

Clinical comparative study of breast-conserving surgery and improved surgical in breast cancer patients

作　　者：方文成[1] 张传平[1] 崔洪侠[1] 袁宗怀[1] 尹强[1] 

机构地区：[1]山东省日照市人民医院普外科,276800

出　　处：《中国综合临床》2015年第7期585-588,共4页Clinical Medicine of China

摘　　要：目的比较保乳手术与改良根治手术在乳腺癌患者中的应用价值。方法选取2005年2月至2010年10月我院收治的乳腺癌女性患者168例，分为保乳手术组80例和改良手术组88例，对两组患者进行为期3年的随访调查研究。比较分析两组患者手术时间、术中出血量、术后引流量、术后引流时间以及住院时间；3年内并发症发生情况、局部复发情况、远处转移情况以及生存率等临床相关指标；两组术后3年乳房美容效果、患者心理焦虑评分以及生存质量评分。结果保乳手术组并发症发生率（12．50％，10／80）低于改良手术组（29．55％，26／88），两组比较差异有统计学意义（χ^2=7．23，P〈O．05）。保乳手术组手术时间[（72．68±5．28）min]、术中出血量[（39．21±8．59）m1]、术后引流量[（162．25＋28．56）m1]、术后引流时间[（8．16±2．58）d]以及住院时间[（11．43±1．98）d]，低于改良手术组[（92．48±6．01）min、（68．26±10．23）ml、（343．29±62．18）ml、（16．59±4／96）d以及（18．47±2．94）d]，两组比较差异均有统计学意义（t值分别为22．72、19．99、24．61、13．99、18．35，P均〈0．05）。保乳手术组3年乳房美容满意率92．50％（74／80）高于改良手术组81．82％（72／88），两组比较差异有统计学意义（χ^2=4．20，P〈0．05）。保乳手术组2年和3年心理焦虑评分[（40．02±2．63）分和（34．26±3．59）分]低于改良手术组[（42．58±2．37）、（39．85±2．10）分]，保乳手术组3年生存质量评分[（67．58±11．26）分]高于改良手术组[（50．85±10．42）分]，差异均有统计学意义（P均〈O．05）。结论保乳手术能够有效地降低乳腺癌患者并发症的发生率及心理焦虑情况，改善患者临床相关指标，提高患者乳房美容满意率及生活质量。Objective To comparative analysze of the applications value of breast-conserving surgery and improved surgical in breast cancer patients. Methods One hundred and sixty-eight female breast cancer patients from February 2005 to October 2010 in the People＇s Hospital of Rizhaoour hospital were selected. The patients were divided into breast-conserving surgery group （ n = 80） and improved surgical group （ n = 88 ）. The patients in two groups were followed-up and investigated for three years. Operative time, blood loss, postoperative drainage, postoperative drainage time and hospital stay, incidence of complications, local recurrence, distant metastasis and survival after 3 year, satisfaction ratio of breast cosmetology, psychological anxiety scores and quality of life scores after 3 years of the patients in two groups were compared and analyzed. Results The complication rate of breast-conserving surgery group was 12. 50% （10/80）, lower than the improved surgical group, and the difference was significant statistically （ 29. 55% （ 26/88）, χ^2= 7.23, P〈0. 05 ）. The operative time （ （72. 68±5.28 ） min）, blood loss （ （ 39. 21 ± 8. 59 ） ml ）, postoperative drainage （ （ 162.25 ± 28.56 ） ml ）, postoperative drainage time （ （8. 16± 2. 58 ） d） and the length of hospital stay （ （ 11.43± 1.98 ） d） of the patients in breast-conserving surgery group were lower than those of the improved surgical group, and the differences of two groups were significant statistically （ （ 92.48 ± 6. 01 ） min, （ 68.26 ± 10. 23 ） ml, （ 343.29 ± 62. 18 ） ml, （ 16. 59±4. 96） d, （ 18.47 ± 2. 94） d; t = 22.72, 19. 99,24. 61,13.99, 18. 35 ; P 〈 0. 05 ）. The satisfaction rate after 3 years of breast-conserving surgery group was 92. 50%（74/80） ,higher than that of the improved surgical group, and the difference was significant statistically（ 81.82% （72/88） ,χ^2 = 4. 20, P〈0. 05 ）. The psychological anxiety scores after 2 and 3 years of breast-co

关 键 词：保乳手术 改良手术 乳腺癌 

分 类 号：R737.9[医药卫生—肿瘤]