不同手术方式对乳腺癌患者预后及术后生活质量的影响  

Effects of different surgical procedures on clinical outcomes and quality of life in patients with breast cancer

作　　者：郭文利[1] 陆建菊[1] 黄建棋[1] 

机构地区：[1]嘉兴市第一医院乳腺外科,浙江省嘉兴314000

出　　处：《中国基层医药》2017年第4期578-581,共4页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的：探讨手术方式的不同对于乳腺癌患者的临床预后及其术后生存质量的影响。方法回顾性分析93例乳腺癌患者的临床资料，根据手术方式的不同，将其分为保乳手术组（n ＝42）及改良根治术组（n ＝51）。比较两组患者术临床预后及生存质量的不同。结果相比于改良根治术组，保乳手术组术后皮下积液[7．1％（3／42）比25．5％（13／51），χ2＝5．443，P ＝0．020]及上肢肿胀[14．3％（6／42）比37．3％（19／51），χ2＝5．443，P ＝0．020]并发症发生率显著性降低。两组患者在临床结局方面差异均无统计学意义（P ＞0.05）。在生存质量方面：保乳手术组在情感状态[（23．14±2．71）分比（19．98±2．69）分，t ＝5.606，P ＝0.000）]、功能状态[（24．61±2．72）分比（23．18±2．99）分，t ＝2．372，P ＝0．020]及总分[（116．42±12．439）分比（111．18±10．75）分，t ＝2．147，P ＝0．034]方面评分均明显高于改良根治术组；患者焦虑自我评分得分也显著性低于改良手术组[（47．89±8．32）分比（52．46±7．38）分，t ＝2．767，P ＝0．007]。结论相比于改良根治术，乳腺癌保乳手术可有效降低术后并发症发生率，提高患者生存质量。Objective To investigate the effects of different surgical procedures on clinical outcomes and quality of life（QOL）in patients with breast cancer.Methods The clinical data of 93 patients with breast cancer were retrospectively reviewed.According to the different surgical methods,they were divided into two groups：breast conserving surgery（BCS）group（n =42）and modified radical mastectomy（MRM）group（n =51）.Clinical outcomes and QOL score between the two groups were compared.Results Compared with MRM group,the incidence rate of complication in BCS group was significantly lower in subcutaneous exudate[7.1%（3 /42）vs.25.5%（13 /51）,χ2 =5.443,P =0.020]and upper limb swelling[14.3%（6 /42）vs.37.3%（19 /51）,χ2 =5.443,P =0.020].In the aspect of QOL score,BCS group showed significantly higher score in emotional well -being [（23.14 ±2.71）points vs.（19.98 ±2.69）points,t =5.606,P =0.000],functional well -being[（24.61 ±2.72）points vs.（23.18 ± 2.99）points,t =2.372,P =0.020]and total score of QOL[（116.42 ±12.439）points vs.（111.18 ±10.75）points, t =2.147,P =0.034].BCS group showed significantly lower score in self -rating anxiety scale test[（47.89 ±8.32） points vs.（52.46 ±7.38）points,t =2.767,P =0.007].Conclusion Compared with MRM,BCS can effectively decrease the incidence rate of complications and increase the QOL in breast cancer patients.

关 键 词：乳腺肿瘤 保乳手术 改良根治术 临床预后 生存质量 

分 类 号：R737.9[医药卫生—肿瘤]