超声引导下染色剂标记切缘保乳手术在早期乳腺癌患者中的应用效果评价  

Evaluation of the effect of ultrasound guided dye labeling surgical margin breast conserving surgery in patients with early breast cancer

作　　者：张宏旭[1] 刘海旺[2] 王助新[1] 胡大为[1] 刘建平[1] 刘汉成[1] 马立辉[1] ZHANG Hong-xu;LIU Hai-wang;WANG Zhu-xin;HU Da-wei;LIU Jian-ping;LIU Han-cheng;MA Li-hui(Department of Breast Surgery,Affiliated Hospital of Chengde Medical College,Chengde 067000,Hebei,China;Department of Pathology,Affiliated Hospital of Chengde Medical College,Chengde 067000,Hebei,China)

机构地区：[1]承德医学院附属医院乳腺外科,河北承德067000 [2]承德医学院附属医院病理科,河北承德067000

出　　处：《川北医学院学报》2021年第11期1436-1440,共5页Journal of North Sichuan Medical College

基　　金：河北省承德市科技支撑计划(201801A032)。

摘　　要：目的:探讨超声引导下染色剂标记切缘保乳手术在早期乳腺癌患者中的应用效果。方法:根据是否行超声引导下染色剂标记将88例行保乳手术治疗的早期乳腺癌患者分为对照组(n=44)与观察组(n=44)。对照组患者行常规保乳手术,观察组患者行超声引导下染色剂亚甲蓝标记切缘保乳手术;比较两组患者手术相关指标、手术精准性、术后3个月上肢功能恢复情况、上肢淋巴水肿发生情况及美容效果。结果:观察组患者手术时间和住院时间均短于对照组(P<0.05),且术中出血量少于对照组(P<0.05)。观察组患者最大切缘≤2 cm患者占比高于对照组(P<0.05),切缘阳性率低于对照组(P<0.05)。观察组患者二次扩切后切缘均为阴性,对照组二次扩切后仍有4例患者切缘阳性,改行乳腺全切术。术后1周,两组患者患侧上肢功能状况及优良率低于术前,且于术后3个月提升,但略低于术前水平,差异均无统计学意义(P>0.05)。术后3个月,两组术后水肿发生率比较,差异无统计学意义(P>0.05)。术后3个月,观察组患者美容效果优于对照组(P<0.05),美容效果优良率高于对照组(93.18%vs.77.27%,P<0.05)。结论:超声引导下亚甲蓝染色剂标记切缘保乳手术有利于降低早期乳腺癌患者术中出血量,缩短手术时间及缩短住院时间,提升手术精准性及美容效果,且患者术后上肢功能恢复情况与传统保乳手术相当,不增加术后上肢淋巴水肿发生风险。Objective:To investigate the effect of ultrasound guided dye labeling surgical margin breast conserving surgery in patients with early breast cancer.Methods:88 patients with early breast cancer who underwent breast conserving surgery were selected and divided into control group(n=44)and observation group(n=44)according to whether or not ultrasound guided staining was used.The patients in the control group underwent routine breast conserving surgery,and the patients in the observation group underwent breast conserving surgery with methylene blue marker under ultrasound guidance.The operation related indexes,surgical accuracy,the recovery of upper limb function,the occurrence of upper limb lymphedema and the cosmetic effect of the two groups were compared.Results:The operation time of the observation group was lower than that of the control group(P<0.05),the amount of intraoperative bleeding was lower than that of the control group(P<0.05),and the hospital stay was shorter than that of the control group(P<0.05).The proportion of patients with maximum margin≤2 cm in the observation group was higher than that in the control group(P<0.05),and the positive rate of margin was lower than that in the control group(P<0.05).The margin of the observation group was negative after the second expansion,and 4 patients in the control group were still positive after the second expansion,so they were converted to total mastectomy.1 week after operation,the functional status and excellent and good rate of the affected upper limb of the two groups were lower than those before operation,and increased 3 months after operation,but slightly lower than the preoperative level,there was no significant difference between the two groups(P>0.05).3 months after operation,there was no significant difference in the incidence of postoperative edema between the control group and the observation group(P>0.05).3 months after operation,the cosmetic effect of the observation group was better than that of the control group(P<0.05),and the excellent an

关 键 词：早期乳腺癌 彩色多普勒超声 染色剂标记 亚甲蓝 上肢功能 上肢淋巴水肿 

分 类 号：R737.9[医药卫生—肿瘤] R445.1[医药卫生—临床医学]