环乳晕入路保留乳头乳晕乳腺癌改良根治术与根治性乳房切除术治疗乳腺癌患者的效果比较  

Comparison of effects of modified radical mastectomy with preservation of nipple and areola through circumareolar approach and radical mastectomy for breast cancer

作　　者：林传明 彭雪峰 LIN Chuanming;PENG Xuefeng(Department of Surgery of Fenyi County Maternal and Child Health Hospital,Xinyu 336600 Jiangxi,China;Department of Surgery of Fenyi County People’s Hospital,Xinyu 336600 Jiangxi,China)

机构地区：[1]分宜县妇幼保健院外科,江西新余336600 [2]分宜县人民医院外科,江西新余336600

出　　处：《中国民康医学》2024年第22期154-156,160,共4页Medical Journal of Chinese People’s Health

摘　　要：目的:比较环乳晕入路保留乳头乳晕乳腺癌改良根治术与根治性乳房切除术治疗乳腺癌患者的效果。方法:选取2021年4月至2023年1月该院收治的72例乳腺癌患者进行前瞻性研究,按照随机数字表法将其分为研究组38例与对照组34例。对照组采用根治性乳房切除术治疗,研究组采用环乳晕入路保留乳头乳晕乳腺癌改良根治术治疗,比较两组围术期指标(术中出血量、手术时间)水平,手术前后创伤应激指标[去甲肾上腺素(NE)、皮质醇(Cor)]水平,并发症发生率,生命质量[卡氏功能状态(KPS)、乳腺癌患者生命质量测定量表(FACT-B)]评分,以及局部复发率和远处转移率。结果:研究组术中出血量少于对照组,手术时间长于对照组,差异均有统计学意义(P<0.05);术后3 d,两组NE、Cor水平均高于术前,但研究组低于对照组,差异有统计学意义(P<0.05);研究组术后并发症发生率低于对照组,差异有统计学意义(P<0.05);术后3个月,两组KPS、FACT-B评分均高于术前,且研究组高于对照组,差异有统计学意义(P<0.05);两组局部复发率和远处转移率比较,差异均无统计学意义(P>0.05)。结论:环乳晕入路保留乳头乳晕乳腺癌改良根治术治疗乳腺癌患者可提高生命质量评分,减少术中出血量,以及降低创伤应激指标水平和术后并发症发生率的效果优于根治性乳房切除术治疗,但需延长手术时间。Objective:To compare effects of modified radical mastectomy with preservation of nipple and areola through circumareolar approach and radical mastectomy for breast cancer.Methods:A prospective study was conducted on 72 patients with breast cancer admitted to the hospital from April 2021 to January 2023.According to the random number table method,they were divided into study group(38 cases)and control group(34 cases).The control group was treated with radical mastectomy,while the study group was treated with modified radical mastectomy with preservation of nipple and areola through circumareolar approach.The levels of perioperative indicators(intraoperative blood loss,operation time),the levels of traumatic stress indicators[norepinephrine(NE),cortisol(Cor)]before and after the surgery,the incidence of complications,the quality of life[Karnofsky performance status(KPS),functional assessment of cancer therapy-breast(FACT-B)]score,the local recurrence rate,and the distant metastasis rate were compared between the two groups.Results:The intraoperative blood loss in the study group was less than that in the control group,the operation time was longer than that in the control group,and the differences were statistically significant(P<0.05).Three days after the surgery,the levels of NE and Cor in the two groups were higher than those before the surgery,but those in the study group were lower than those in the control group,and the differences were statistically significant(P<0.05).The incidence of postoperative complications in the study group was lower than that in the control group,and the difference was statistically significant(P<0.05).Three months after the surgery,the KPS and FACT-B scores of the two groups were higher than those before the surgery,those of the study group were higher than those of the control group,and the differences were statistically significant(P<0.05).However,there were no significant differences in the local recurrence rate and the distant metastasis rate between the two groups(P>0.05).Conc

关 键 词：乳腺癌 环乳晕入路保留乳头乳晕乳腺癌改良根治术 根治性乳房切除术 生命质量 创伤应激 出血量 并发症 

分 类 号：R737.9[医药卫生—肿瘤]