保留乳头乳晕手术对中青年早期乳腺癌患者预后乳房外观及婚姻质量的影响  

The effect of nipple-areola-sparing mastectomy on prognosis,breast appearance and marital quality of young and middle-aged patients with early breast cancer

作　　者：闫卫甫[1] 王金柱[1] Yan Weifu;Wang Jinzhu(The Second Affiliated Hospital of Luohe Medical College,Luohe 462300,Henan,China)

机构地区：[1]漯河医学高等专科学校第二附属医院,河南漯河462300

出　　处：《临床心身疾病杂志》2022年第3期35-40,共6页Journal of Clinical Psychosomatic Diseases

摘　　要：目的探讨保留乳头乳晕手术对中青年早期乳腺癌患者预后、乳房外观及婚姻质量的影响。方法将85例中青年早期乳腺癌患者按照随机数字表法分为研究组42例与对照组43例。研究组给予保留乳头乳晕手术,对照组给予传统乳腺癌改良根治术。比较两组手术时间、住院时间、术中出血量、术后引流量、并发症发生率、术后1 a乳房外观美观度。比较术前、术后3 d、术后1周末两组糖类抗原153、癌胚抗原、血管内皮生长因子水平。比较术前、术后6个月末、术后1 a末两组Olson婚姻质量调查问卷评分。比较两组局部复发、远处转移率。结果研究组手术时间及住院时间显著短于对照组(P<0.01),术中出血量、术后引流量显著少于对照组(P<0.01),术后并发症发生率显著低于对照组(P<0.05),术后1 a乳房外观美观度显著优于对照组(P<0.05)。术后3 d、术后1周末两组血清糖类抗原153、癌胚抗原、血管内皮生长因子水平均较术前显著降低(P<0.01),两组间比较差异无统计学意义(P>0.05)。术后6个月末、术后1 a末两组Olson婚姻质量调查问卷各维度评分均较术前显著降低(P<0.05或0.01),研究组显著高于对照组(P<0.05或0.01)。术后1 a末两组局部复发、远处转移率比较差异无统计学意义(P>0.05)。结论保留乳头乳晕手术可降低中青年早期乳腺癌患者术中出血量及术后引流量,缩短手术时间及住院时间,减少并发症的发生,减轻手术对乳房外观美观度及婚姻质量的影响,与传统乳腺癌改良根治术效果及预后相当。Objective To investigate the effect of nipple-areola-sparing mastectomy on prognosis,breast appearance and marital quality of young and middle-aged patients with early breast cancer.Methods A total of 85 young and middle-aged patients with early breast cancer were divided into an observation group(n=42)and a control group(n=43)by random number table method.The study group was given nipple-areola-sparing mastectomy,while the control group was treated with traditional modified radical mastectomy.The operation time,hospital stay,intraoperative bleeding,postoperative drainage volume,incidence of complications and breast appearance 1 year after operation were compared between the two groups.The levels of carbohydrate antigen 153(CA153),carcinoembryonic antigen(CEA)and vascular endothelial growth factor(VEGF)were compared before operation,3 d after operation and 1 weekend after operation.The scores of Olson marriage quality questionnaire(ENRICH)before operation,at the end of 6 months after operation and at the end of 1 year after operation were compared between the two groups.Local recurrence rate and distant metastasis rate were compared between the two groups.Results The operation time and hospital stay in the study group were significantly shorter than those in the control group(P<0.01),and the intraoperative blood loss and postoperative drainage volume were significantly less than those in the control group(P<0.01),the incidence of postoperative complications was significantly lower than that in the control group(P<0.05),and the breast appearance was significantly better than that in the control group(P<0.05).At 3 d and 1 weekend after surgery,the levels of serum CA153,CEA and VEGF in both groups were significantly lower than those before surgery(P<0.01),and there was no significant difference between the two groups(P>0.05).At the end of 6 months and 1 year after operation,the ENRICH dimension scores in both groups were significantly lower than those before operation(P<0.05 or 0.01),and the study group was signific

关 键 词：保留乳头乳晕手术 中青年 早期 乳腺癌 乳房外观 婚姻质量 

分 类 号：R737.9[医药卫生—肿瘤]