环乳晕切口入路保留乳头乳晕复合体的乳房切除术联合即刻乳房重建对乳腺癌病人乳腺美观性、应激反应指标的影响  

Effects of NSM via circular areola incision approach combined with immediate breast reconstruction on breast aesthetics and stress response indicators in patients with breast cancer

作　　者：刘亦晴[1] 邹华伟[1] 丁华[1] LIU Yiqing;ZOU Huawei;DING Hua(Department of Thyroid and Breast Surgery,Zhoukou Central Hospital,Zhoukou,He'nan 466600,China)

机构地区：[1]周口市中心医院甲状腺乳腺外科,河南周口466600

出　　处：《安徽医药》2024年第2期348-351,共4页Anhui Medical and Pharmaceutical Journal

摘　　要：目的 探讨环乳晕切口入路保留乳头乳晕复合体的乳房切除术(NSM)联合即刻乳房重建对乳腺癌病人乳腺美观性、应激反应指标的影响。方法 选取2017年8月至2020年8月周口市中心医院收治的93例乳腺癌病人,采用随机数字表法分为两组,对照组46例采用放射状切口手术治疗,观察组47例采用环乳晕切口入路NSM联合即刻乳房重建治疗,比较两组病人围手术期指标、手术并发症发生情况、乳腺美观性指标、应激反应指标[超氧化物歧化酶(SOD)、晚期氧化蛋白产物(AOPP)、皮质醇(Cor)]变化。结果 观察组手术时间为(132.48±15.69)min,显著大于对照组(P<0.05),住院时间为(7.41±0.83)d,显著小于对照组(P<0.05);两组病人手术切口感染、皮瓣积液、乳头凹陷、切口愈合不良等并发症发生情况差异无统计学意义(P>0.05),但观察组手术并发症总发生率为2.13%,显著低于对照组的17.39%(P<0.05);观察组病人术后7 d切口瘢痕、乳房外形、双乳对称性、整体美学效果评分分别为(3.26±0.33)分、(3.94±0.41)分、(3.33±0.34)分、(4.05±0.41)分,术后1个月评分分别为(3.85±0.34)分、(4.19±0.27)分、(3.86±0.25)分、(4.28±0.19)分,均显著高于对照组(P<0.05)。术后观察组SOD水平为(73.40±7.35)U/mL,显著高于对照组(P<0.05),AOPP、Cor水平分别为(11.03±1.05)μmol/L、(192.78±19.34)nmol/L,显著均低于对照组(P<0.05)。结论 环乳晕切口入路NSM联合即刻乳房重建治疗乳腺癌病人可有效减少手术并发症的发生,提高病人乳腺美观性,缓解应激反应指标的变化。Objective To investigate the effects of nipple-areola complex sparing mastectomy(NSM)via circular areola incision ap⁃proach combined with immediate breast reconstruction on breast aesthetics and stress response indicators in patients with breast cancer.Methods A total of 93 patients with breast cancer treated in the Zhoukou Central Hospital between August 2017 and August 2020 were selected as the research subjects and were randomly divided into two groups.Forty-six cases in the control group were treated with radial incision approach surgery,and 47 cases in the observation group were given circular areola incision approach NSM combined with immediate breast reconstruction.The perioperative indicators,occurrence of surgical complications,breast aesthetics indicators and stress response indicators[superoxide dismutase(SOD),advanced oxidation protein product(AOPP),cortisol(Cor)]between the two groups were compared.Results The surgical time of observation group was(132.48±15.69)min,which was significantly longer than that of control group(P<0.05);the hospital stay was(7.41±0.83)d,which was significantly shorter than that of control group(P<0.05).There were no significant differences in the occurrence of complications such as surgical incision infection,valve effusion,nipple depression and poor incision healing between the two groups(P>0.05),but the total incidence of surgical complications in the observa⁃tion group(2.13%)was significantly lower than that in the control group(17.39%)(P<0.05).The scores of incision scar,breast shape,breast symmetry and overall aesthetic effect in observation group were(3.26±0.33)points,(3.94±0.41)points,(3.33±0.34)points and(4.05±0.41)points at 7 days after surgery and(3.85±0.34)points,(4.19±0.27)points,(3.86±0.25)points and(4.28±0.19)points at 1 month after surgery,which were significantly higher than those of the control group(P<0.05).The SOD level of observation group was(73.40±7.35)U/mL after surgery,significantly higher than that of control group(P<0.05)while the le

关 键 词：乳腺肿瘤 环乳晕切 NSM 即刻乳房重建 应激反应 

分 类 号：R737.9[医药卫生—肿瘤]