双环法整形保乳术在早期近乳晕区乳腺癌手术中的临床应用价值  

Clinical application value of double ring plastic breast conserving surgery in early stage near areolar breast cancer

作　　者：刘玉[1] 王超群[2] 高方方 廖浩然 尹斯琪 胡庆捷 李海 何慧芳 宋美姿 LIU Yu;WANG Chao-qun;GAO Fang-fang;LIAO Hao-ran;YIN Si-qi;HU Qing-jie;LI Hai;HE Hui-fang;SONG Mei-zi(The First Affiliated Hospital of Hainan Medical University,Haikou,Hainan 570102,China;不详)

机构地区：[1]海南医学院第一附属医院,海南海口570102 [2]海南医学院附属海南医院

出　　处：《中国妇幼保健》2024年第8期1387-1390,共4页Maternal and Child Health Care of China

基　　金：海南省卫生健康科技创新联合项目(WSJK2024MS197);海南省科技厅重点研发项目(ZDYF2020139,ZDYF2018158);海南省自然科学基金(821MS129);大学生创新创业训练计划项目(X202311810097)。

摘　　要：目的评价双环法整形保乳术治疗近乳晕区早期乳腺癌的临床疗效。方法选取2019年3月—2023年10月海南医学院第一附属医院乳胸外科收治的符合研究标准的早期近乳晕区乳腺癌患者114例为研究对象,采用随机数字表法分为观察组和对照组,观察组57例实施双环法整形保乳术,对照组57例采用传统保乳整形手术,比较两组患者的切除标本量、切缘距离、围术期指标(术中出血量、手术时间及住院日)、乳房美学效果及并发症情况。结果观察组患者切除的乳腺标本量[(86.72±9.76)g]和肿瘤距外科切缘距离[(18.63±4.67)mm]均优于对照组切除的乳腺标本量[(53.67±5.36)g]和肿瘤距外科切缘距离[(13.42±1.37)mm],差异均有统计学意义(t=22.409、8.082,均P<0.05)。观察组患者的临床观察指标[术中出血量(30.52±6.38)ml、手术时间(88.58±12.16)min及住院时间(7.82±1.23)d]与对照组[术中出血量(28.62±6.57)ml、手术时间(85.76±7.99)min及住院时间(7.42±1.31)d]比较,差异均无统计学意义(t=1.566、1.463及1.681,均P>0.05)。在并发症方面(包括血肿形成、乳房疼痛、切口愈合不良及裂开),观察组患者并发症发生率低于对照组,差异有统计学意义(P<0.05)。术后2个月,观察组患者乳房美容评分[(29.36±2.87)分]和优良率(92.98%)均高于对照组乳房美容评分[(24.65±2.82)分]和优良率(70.17%),差异均有统计学意义(t=8.838,χ^(2)=9.864,均P<0.05)。结论近乳晕区早期乳腺癌采用双环法整形保乳术较传统保乳术具有更广的切除范围、更大的切除组织量,更低的并发症发生率,有效提升了乳房的美容效果。Objective To evaluate the clinical effect of double-ring plastic breast-conserving surgery in early breast cancer near the mammary areola.Methods A total of 114 patients with early breast cancernear the mammary areola at the First Affiliated Hospital of Hainan Medical College from March 2019 to October 2023 were selected as the research objects They were divided into observation group and control group by random number table,57 patients in the observation group were treated with double ring plastic surgery,and 57 patients in the control group were treated with traditional plastic surgery.The size of excision specimens,the distance of resection margin and perioperative indexes were compared between the two groups(intraoperative blood loss,operation time and hospital stay),breast aesthetic effect and complications.Results The number of breast specimens in the observation group[(86.72±9.76)g],the distance between the tumor and the surgical margin[(18.63±4.67)mm]were better than the control group[(53.67±5.36)g]and the distance from the surgical margin[(13.42±1.37)mm],which were statistically significant(t=22.409,8.082,all P<0.05).Clinical observation indexes of patients in observation group[intraoperative blood loss(30.52±6.38)ml,operative time(88.58±12.16)min and length of stay(7.82±1.23)d]versus the control group[intraoperative blood loss(28.62±6.57)ml,operative time(85.76±7.99)min and length of stay(7.42±1.31)d],None were statistically significant(t=1.566,1.463 and 1.681,all P>0.05).In terms of complications(including hematoma formation,breast pain,poor incision healing and dehiscence),the complication incidence of the observation group patients was lower than the control group,and the difference was statistically significant(P<0.05).In two months after surgery,the breast cosmetic score[(29.36±2.87)],excellent and good rate(92.98%)were higher than the breast cosmetic score[(24.65±2.82)]and excellent rate(70.17%)were statistically significant(t=8.838,χ^(2)=9.864,all P<0.05).Conclusion Compared with non

关 键 词：双环法 乳腺癌 整形保乳术 外科切缘 美容效果 

分 类 号：R737.9[医药卫生—肿瘤]