保乳联合前哨淋巴结活检治疗早期乳腺癌  

Treatment of early breast cancer with breast-conserving surgery combined with sentinel-lymph-node biopsy

作　　者：陈月凤[1] 陈达丰[1] 钟伟 陈华福 周松[1] CHEN Yue-feng;CHEN Da-feng;ZHONG Wei;CHEN Hua-fu;ZHOU Song(Department of General Surgery,Southeast Hospital Affiliated to Xiamen University/the 909th Hospital of the Joint Logistics Support Force,PLA,Zhangzhou 363000,Fujian,China)

机构地区：[1]厦门大学附属东南医院(解放军联勤保障部队第九○九医院)普通外科,漳州363000

出　　处：《东南国防医药》2020年第6期617-621,共5页Military Medical Journal of Southeast China

摘　　要：目的比较保乳联合前哨淋巴结活检术与改良根治术治疗乳腺癌的围手术期及临床相关指标的优劣。方法回顾性分析2013年1月至2019年6月厦门大学附属东南医院术前活检病理确诊的乳腺癌患者临床资料,保乳联合前哨淋巴结活检术50例早期乳腺癌患者为保乳组,同期行乳腺癌改良根治术50例患者为改良根治组。统计2组患者围手术期指标包括手术时间、术中出血量、腋下术后总引流量、腋下引流管拔管时间,随访调查术后半年患侧乳房的美容效果及患侧肩关节功能情况。结果保乳组在手术时间[(155.91±25.96)min]、腋下引流管拔管时间[(5.86±8.18)d]明显短于改良根治组[(167.12±18.51)min、(12.01±10.82)d,P<0.05],术中出血量[(46.92±13.66)mL]、术后腋下引流量[(107.69±6.48)mL]均少于改良根治组[(68.87±9.81)mL、(391.27±9.48)mL,P<0.01]。保乳组患侧乳房均保持较好的乳房外形,优良率达94%。保乳组术后患侧肩关节功能评分较高(P<0.01)。结论保乳联合前哨淋巴结活检手术在围手术期指标、术后患侧乳房的美容效果、肩关节功能等方面均优于乳腺癌改良根治术,符合保乳条件的患者应争取保乳手术。Objective Comparison of the perioperative and clinical indexes between breast conserving combined with sentinel lymph node biopsy and modified radical mastectomy for breast cancer.Methods A retrospective analysis of 50 breast cancer patients treated with breast-conserving surgery combined with sentinel lymph node biopsy that were made up of the breast-conserving group,and another 50 patients with modified radical mastectomy were selected as the modified radical mastectomy group.By following up two groups of patients,the indexes of perioperative period including operation time,intraoperative blood loss,total drainage volume after axillary operation,and extubation time of subaxillary drainage tube,the beauty effect of the affected breast and the function of shoulder joint were investigated after half a year.Results The operation time[(155.91±25.96)min]and axillary drainage tube extubation time[(5.86±8.18)d]in the breast-conserving group were significantly shorter than those in the modified radical mastectomy group[(167.12±18.51)min,(12.01±10.82)d,P<0.05],the amount of bleeding during operation[(46.92±13.66)mL]and the amount of axillary drainage after operation[(107.69±6.48)mL]were less than those the modified radical mastectomy group[(68.87±9.81)mL,(391.27±9.48)mL,P<0.01].The affected breast in the breast-conserving group maintained the better breast shape with 94%excellence rate and higher shoulder function score(P<0.01).Conclusion Breast-conserving surgery combined with sentinel lymph node biopsy is better than the control group in the perioperative period,beauty effect of affected breast and shoulder function.It is strongly recommended that patients who meet the requirements of breast preservation surgery should undertake a breast-conserving surgery.

关 键 词：保乳手术 前哨淋巴结活检 乳腺癌改良根治术 效果观察 

分 类 号：R737.9[医药卫生—肿瘤]