超声引导下微创旋切术对乳腺多发性肿块患者的治疗效果及其对术后疼痛、应激反应的影响  

Effect of Ultrasound-guided Minimally Invasive Gyrotomy on Patients with Multiple Breast Masses and Its Influence on Postoperative Pain and Stress Response

作　　者：赵严冬 ZHAO Yandong(Department of Nail and Breast Surgery,Xuzhou Mining Group General Hospital,Xuzhou,Jiangsu Province,221000 China)

机构地区：[1]徐州矿务集团总医院甲乳外科,江苏徐州221000

出　　处：《世界复合医学》2023年第5期167-170,174,共5页World Journal of Complex Medicine

摘　　要：目的 探讨超声引导下微创旋切术治疗乳腺多发性肿块的疗效,以及其对术后疼痛和应激反应的影响。方法 选取2020年3月—2023年3月徐州矿务集团总医院收治的130例乳腺多发性肿块患者进行回顾性分析。根据手术的方法不同分为微创组(n=65)和常规组(n=65)。常规组应用开放型手术治疗,微创组应用超声引导下的微创旋切术。比较两组临床相关指标、疼痛情况、应激指标、免疫功能、并发症发生率。结果 微创组手术时间、术后瘢痕长度、伤口愈合时间均短于常规组,且术中出血量少于常规组,差异有统计学意义(P<0.05)。微创组术后1、7 d,微创组视觉模拟疼痛评分低于常规组,差异有统计学意义(P<0.05)。术后微创组血浆中皮质醇、去甲肾上腺素、血管紧张素Ⅱ水平均低于常规组,差异有统计学意义(P<0.05)。术后48 h,微创组CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)、自然杀伤细胞(natural killer cell,NK)水平均高于常规组,差异有统计学意义(P<0.05)。微创组并发症发生率为4.62%低于常规组的18.46%,差异有统计学意义(χ^(2)=6.104,P<0.05)。结论 超声引导下微创旋切术治疗乳腺多发性肿块创伤小,可降低患者术后疼痛感,改善应激反应,促进免疫功能恢复,且安全性良好。Objective To investigate the efficacy of ultrasound-guided minimally invasive gyrotomy in the treatment of multiple breast masses and its effect on postoperative pain and stress response.Methods 130 patients with multiple breast masses admitted to Xuzhou Mining Group General Hospital from March 2020 to March 2023 were retrospectively analyzed.They were divided into minimally invasive group (n=65) and conventional group (n=65) according to different surgical methods.The conventional group was treated with open surgery,and the minimally invasive group was treated with ultrasound-guided minimally invasive gyrotomy.Clinical indicators,pain,stress,immune function and complication rate were compared between the two groups.Results The operation time,postoperative scar length and wound healing time in the minimally invasive group were shorter than those in the conventional group,and the intraoperative blood loss was less than that in the conventional group,and the difference was statistically significant (P<0.05).The Visual Analogue Pain score in the minimally invasive group was lower than that in the conventional group 1 and 7 d after surgery,and the difference was statistically significant (P<0.05).The plasma levels of cortisol,norepinephrine and angiotensinⅡin minimally invasive group were lower than those in conventional group,and the differences were statistically significant (P<0.05).48 h after surgery,the levels of CD3^(+),CD4^(+),CD4^(+)/CD8^(+) and natural killer cell (NK) in minimally invasive group were higher than those in conventional group,and the differences were statistically significant (P<0.05).The incidence of complications in the minimally invasive group (4.62%) was lower than in the conventional group (18.46%),and the difference was statistically significant(χ^(2)=6.104,P<0.05).Conclusion Ultrasound-guided minimally invasive rotatectomy in the treatment of multiple breast masses has little trauma,can reduce postoperative pain,improve stress response,promote immune function recovery,and is safe.

关 键 词：超声引导 微创旋切术 乳腺多发性肿块 应激反应 免疫功能 术后疼痛 

分 类 号：R739[医药卫生—肿瘤]