日间乳腺癌保乳术的安全性、经济效益及社会心理满意度分析  

Analysis of the safety,economic benefit and social psychological satisfaction of day breast conserving surgery for breast cancer

作　　者：周娇 肖小潇 杨加彬 冯玉 杨焕佐 邱梦雪 张晴 刘洋[5] 黄明君[5] 梁鹏[5] 杜正贵[1,2] ZHOU Jiao;XIAO Xiaoxiao;YANG Jiabin;FENG Yu;YANG Huanzuo;QIU Mengxue;ZHANG Qing;LIU Yang;HUANG Mingjun;LIANG Peng;DU Zhenggui(Department of General Surgery,West China Hospital,Sichuan University,Chengdu,610041,P.R.China;Breast Disease Center,West China Hospital,Sichuan University,Chengdu,610041,P.R.China;Department of Thyroid and Breast Surgery,The First People’s Hospital of Ziyang,Ziyang,641300,Sichuan,P.R.China;Anesthesia&Operation Center,West China Hospital,Sichuan University,Chengdu,610041,P.R.China;Day Surgery Center,West China Hospital,Sichuan University,Chengdu,610041,P.R.China)

机构地区：[1]四川大学华西医院普通外科,成都610041 [2]四川大学华西医院乳腺疾病中心,成都610041 [3]资阳市第一人民医院甲状腺乳腺外科,四川资阳641300 [4]四川大学华西医院麻醉手术中心,成都610041 [5]四川大学华西医院日间服务中心,成都610041

出　　处：《中国胸心血管外科临床杂志》2025年第2期160-166,共7页Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

基　　金：四川省卫生健康委重点项目(21PJ042);四川大学华西医院孵化项目(2022HXFH004);四川省自然科学基金(2022NSFSC0744);四川省科技厅重点研发项目(2021YFS0104)。

摘　　要：目的探讨乳腺癌保乳术日间手术的安全性、经济效益及心理学效应。方法回顾性收集2020年3月—2021年6月在四川大学华西医院单一医疗组进行乳腺癌日间保乳术(日间组)及住院部保乳术(病房组)患者的人口学资料和临床资料;前瞻性收集2021年6月—2022年6月在四川大学华西医院单一医疗组进行乳腺癌日间保乳术(日间组)及住院部保乳术(病房组)患者的人口学资料、临床资料、医疗交通费用、术前及术后BREAST-Q评分等,分析日间手术的安全性、经济效益及社会心理满意度。结果回顾性研究共纳入42例女性乳腺癌患者,前瞻性研究共纳入39例女性乳腺癌患者。无论在前瞻性还是回顾性研究中,两组患者的平均年龄均<50岁。基线资料方面,仅在前瞻性研究中,两组患者高血压(P=0.022)、新辅助化疗(P=0.037)及术后雌激素受体(P=0.033)差异有统计学意义。术后并发症方面,无论是前瞻性研究还是回顾性研究中,两组患者的外科及麻醉相关并发症差异均无统计学意义(P>0.05)。在前瞻性研究中,日间组患者较病房组医疗费用更少(P=0.002)。在术后社交、性生活、乳房满意度及胸壁情况方面,两组患者差异无统计学意义(P>0.05)。结论在严格的管理规范下,在日间手术中心进行乳腺癌保乳术是安全可靠的,更能节约医疗费用且不会对患者产生较大的心理负担。Objective To investigate the safety,economic benefits and psychological effects of day breast conserving surgery for breast cancer.Methods The demographic data and clinical data of breast cancer patients undergoing day(day surgery group)and ward(ward surgery group)breast conserving surgeries in West China Hospital of Sichuan University from March 2020 to June 2021 were retrospectively collected;the demographic data,clinical data,medical and related transportation costs,and preoperative and postoperative BREAST-Q scores of breast cancer patients undergoing day(day surgery group)and ward(ward surgery group)breast conserving surgery in West China Hospital of Sichuan University from June 2021 to June 2022 were prospectively collected.The safety,economic benefit,and psychological satisfaction of day surgery was analyzed.Results A total of 42 women with breast cancer were included in the retrospective study and 39 women with breast cancer were included in the prospective study.In both prospective and retrospective studies,the mean age of patients in both groups were<50 years.There were only statistical differences between the two groups in the aspects of hypertension(P=0.022),neoadjuvant chemotherapy(P=0.037)and postoperative pathological estrogen receptor(P=0.033)in the prospective study.In postoperative complications,there were no statistical differences in the surgical-related complications or anesthesia-related complications between the two groups in either the prospective study or the retrospective study(P>0.05).In terms of the overall cost,we found that the day surgery group was more economical than the ward surgery group in the prospective study(P=0.002).There were no statistical differences in postoperative psychosocical well-being,sexual well-being,satisfaction with breasts or chest condition between the two groups(P>0.05).Conclusion It is safe and reliable to carry out breast conserving surgery in day surgery center under strict management standards,which can save medical costs and will not cause great psycho

关 键 词：日间手术 保乳术 并发症 经济效益 心理效应 

分 类 号：R73[医药卫生—肿瘤]