腹腔镜辅助下乳腺癌根治联合大网膜填充重建对患者上肢功能保护及美容效果的影响  

Effect of laparoscopic-assisted radical mastectomy combined with omentum filling on upper limb functional protection and cosmetology

作　　者：桑凯[1] 易彤波[1] 曹赣[2] 周剑[1] 葛兰[1] 

机构地区：[1]泰州市人民医院甲状腺乳腺外科,江苏泰州225300 [2]泰州市人民医院普外科,江苏泰州225300

出　　处：《现代医学》2017年第9期1271-1275,共5页Modern Medical Journal

摘　　要：目的:探讨腹腔镜辅助下乳腺癌根治联合大网膜填充重建对患者上肢功能保护及美容效果的影响。方法:将2014~2017年来我院接受手术治疗的乳腺癌患者按照手术方式不同分为对照组(乳腺癌保乳切除术)及观察组(乳腺癌保乳切除术+腹腔镜辅助大网膜填充重建),比较两组患者手术情况差异以及手术对患者上肢功能、乳房美容效果、术后并发症及患者满意度的影响。结果:手术情况比较,观察组除了手术用时长于对照组外,术中出血量、术后引流时间及引流量、住院时间均少于对照组;对上肢功能影响的结果显示,观察组与对照组在发生麻木(7.4%vs 33.3%)、浮肿(2.9%vs 20%)、外展障碍(11.8%vs 43.4%)的差异上具有统计学意义;此外,观察组与对照组在美容优良率(94.1%vs 40.0%)、并发症发生率(2.9%vs20.0%)、满意度[(16.3±2.8)分vs(7.6±4.4)分]上差异均具有统计学意义。结论:乳腺癌保乳切除术联合腹腔镜辅助大网膜填充重建较单独乳腺癌保乳切除术具有改善患者术后恢复情况,减少手术对患者上肢功能影响,提高乳房美容优良率及患者满意度的优点。Objective： To explore the effect of laparoscopic-assisted radical resection of breast can combined with omentum reconstruction on functional protection of upper limbs and cosmetic effect.Methods： The breast cancer patients who underwent surgical treatment in our hospital from 2014 to 2017 were divided into control group （breast conserving surgery） and observation group （breast conserving surgery ＋ laparoscopic assisted omentum filling）,and the differences of operation between the two groups and the effect of surgery on upper limb function,breast cosmetic effect,postoperative complications and patient satisfaction were compared.Results： Comparison of surgical conditions,the bleeding volume,postoperative drainage time,drainage volume and length of hospital stay in the observation group were shorter than those in the control group.The detecting results of the upper limb function showed that the differences on numbness （7.4% vs 33.3%）,edema （2.9% vs 20%）,abducens disorder （11.8% vs 43.4%） between observation group and control group were significant.In addition,there was significant difference between the observation group and the control group on the excellent rate of beauty （94.1% vs 40.0%）,the incidence of complications （2.9% vs 20.0%）,and satisfaction （16.3 ± 2.8 vs 7.6 ± 4.4）.Conclusion： Breast conserving surgery combined with laparoscopy-assisted omentum reconstruction compared with breast conserving surgery alone can improve the patient＇s postoperative recovery,reduce the impact of surgery on upper limb function,improve the excellent rate of breast beauty and patient satisfaction.

关 键 词：乳腺癌 腹腔镜检查 大网膜填充 乳房美容 

分 类 号：R737.9[医药卫生—肿瘤] R616.5[医药卫生—临床医学]