乳腺癌保乳术后应用紫杉醇脂质体对背阔肌肌瓣修复的疗效研究  

Effect of Paclitaxel Liposome on Latissimus Dorsi Muscle Flap Repair after Breast Conserving Surgery

作　　者：芮小平[1] 肖献秋 王力[1] 莫淋 祝梦娇 RUI Xiao-ping;XIAO Xian-qiu;WANG Li;MO Lin;ZHU Meng-jiao(Department of Thyroid and Breast Surgery,The 904 Hospital of Joint Service Support Force of Chinese People's Liberation Army,Wuxi,Jiangsu,214044,China;Wuxi School of Clinical Medicine,Anhui Medical University,Wuxi,Jiangsu,214044,China)

机构地区：[1]中国人民解放军联勤保障部队第904医院甲乳外科,江苏无锡214044 [2]安徽医科大学无锡临床医学院,江苏无锡214044

出　　处：《现代生物医学进展》2020年第24期4785-4788,4784,共5页Progress in Modern Biomedicine

基　　金：江苏省青年医学重点人才基金项目(QNRC2016883)。

摘　　要：目的:研究紫杉醇脂质体在乳腺癌保乳术后对背阔肌肌瓣修复的应用价值。方法:选取本院2015年1月~2018年10月收治的65例行保乳术治疗的乳腺癌患者作为研究对象,采用随机数表法将患者分为观察组33例和对照组32例,术后均行背阔肌肌瓣修复手术,对照组予以单纯的表柔比星+环磷酰胺+多西他赛进行术后化疗,观察组予以表柔比星+环磷酰胺+紫杉醇脂质体进行术后化疗。结果:观察组患者达到完全缓解(CR)14例,部分缓解(PR)13例,稳定(SD)5例,进展(PD)1例,客观缓解率(ORR)为81.82%;对照组患者达到CR 11例,PR 8例,SD 11例,PD 2例,ORR为59.38%,差异有统计学意义(P<0.05)。观察患者的乳房修复美学评价优良率90.91%较对照组的71.88%升高(P<0.05);观察组满意度为90.91%,对照组满意度为78.13%,两组比较有统计学差异(P<0.05)。两组患者术后并发症发生情况比较无明显差异(P>0.05)。两组化疗相关的腹泻和呕吐等不良反应发生率比较有统计学差异(P<0.05)。结论:乳腺癌保乳术后应用紫杉醇脂质体对背阔肌肌瓣修复的疗效较好,安全性较理想。Objective:To study and analyze the application of paclitaxel liposome in the repair of latissimus dorsi muscle flap after breast conserving surgery.Methods:65 patients with breast cancer treated by breast conserving surgery in our hospital from January 2015 to October 2018 were selected as the research objects.The patients were divided into observation group(33 cases)and control group(32 cases)by random number table method.All patients underwent latissimus dorsi muscle flap repair surgery.The control group was given epirubicin,cyclophosphamide and docetaxel for postoperative chemotherapy,and the observation group was given epirubicin,cyclophosphamide and paclitaxel liposome for postoperative chemotherapy.Results:In the observation group,14 patients achieved complete remission(CR),13 patients achieved partial remission(PR),5 patients achieved stable remission(SD),and 1 patient achieved progressed(PD).The objective response rate(ORR)of the observation group was 81.82%.In the control group,11 patients achieved CR,8 patients achieved PR,11 patients achieved SD,2 patients achieved PD,and the ORR was 59.38%.The difference was statistically significant(P<0.05).The excellent and good rate of aesthetic evaluation of breast repair was 90.91%in the observation group,which was higher than 71.88% in the control group(P<0.05).The satisfaction rate of the observation group was 90.91%,and that of the control group was 78.13%,with statistical difference between the two groups(P<0.05).There was no significant difference in postoperative complications between the two groups(P>0.05).There was significant difference in the incidence of diarrhea and vomiting between the two groups(P<0.05).Conclusion:Paclitaxel liposome is effective and safe for latissimus dorsi muscle flap repair after breast conserving surgery.

关 键 词：乳腺癌 保乳术 阔背肌肌瓣修复 紫杉醇脂质体 

分 类 号：R737.9[医药卫生—肿瘤]