经乳晕保乳术与改良根治术联合腋窝淋巴结清扫治疗早期乳腺癌患者的临床效果观察  

Clinical Effect of Breast Conserving Surgery via Areola and Modified Radical Mastectomy Combined with Axillary Lymph Node Dissection in the Treatment of Early Breast Cancer

作　　者：张慧 墨杰 刘春红 王骞 Zhang Hui;Mo Jie;Liu Chunhong(Breast Department,Kaifeng Cancer Hospital,Kaifeng,Henan,475000,China)

机构地区：[1]开封市肿瘤医院乳腺科,河南开封475000

出　　处：《黑龙江医学》2025年第3期283-285,289,共4页Heilongjiang Medical Journal

摘　　要：目的:探讨经乳晕保乳术与改良根治术联合腋窝淋巴结清扫(ALND)治疗早期乳腺癌患者的临床效果。方法:回顾性分析2021年6月—2022年12月开封市肿瘤医院收治的64例早期乳腺癌患者临床资料,根据手术方法的不同将其分为对照组和观察组,每组各32例。对照组患者接受改良根治术联合ALND治疗,观察组患者接受经乳晕保乳术联合ALND治疗。比较两组患者手术相关指标、术后生活质量、肩关节活动度、乳房美容满意度及并发症发生情况。结果:观察组患者手术时间、腋窝拔管时间短于对照组患者,观察组患者出血量、腋窝引流量少于对照组患者,差异均有统计学意义(t=4.706、11.251、9.067、6.373,P<0.001)。观察组患者心理、社会、躯体、物质生活状态评分高于对照组患者,差异均有统计学意义(t=5.520、7.086、5.884、6.305,P<0.001)。术后,观察组患者前屈、外展、内收、后伸、外旋、内旋等肩关节活动度高于对照组患者,差异均有统计学意义(t=6.112、6.943、5.703、5.046、7.331、8.577,P<0.001)。观察组患者乳房美容总满意度高于对照组患者,差异均有统计学意义(χ^(2)=7.585,P<0.05)。两组患者并发症总发生率比较,差异无统计学意义(χ^(2)=0.642,P>0.05)。结论:相较于改良根治术联合ALND治疗,经乳晕保乳术联合ALND治疗早期乳腺癌患者的效果更好,术后并发症少、恢复快,对患者肩关节活动度的影响较小,有利于提高其生活质量及对乳房美容的满意度。Objective:To investigate the clinical effect of breast preservation and modified radical resection and axillary lymph node dissection(ALND)in early breast cancer.Methods:Clinical data of 64 patients with early breast cancer admitted to the hospital from June 2021 to December 2022 were retrospectively analyzed.The patients in the control group(n=32)received modified radical resection plus ALND treatment,and the observation group(n=32)received transareolar breast-conserving plus ALND treatment.The control group underwent modified radical resection+ALND treatment,and the observation group underwent transareola breast-conserving surgery+ALND treatment.Surgery-related indicators,postoperative quality of life,shoulder mobility,breast cosmetic satisfaction,and the occurrence of complications were compared between the two groups.Results:The operation time and axillary extubation time of observation group were shorter than those of control group,and the blood loss and axillary drainage volume of observation group were less than those of control group,with statistically significant difference(t=4.706,11.251,9.067,6.373;P<0.001).The scores of psychological,social,physical and material life status in observation group were higher than those in control group,and the differences were statistically significant(t=5.520,7.086,5.884,6.305;P<0.001).After surgery,the shoulder joint motion of the observation group was higher than that of the control group,with statistically significant difference(t=6.112,6.943,5.703,5.046,7.331,8.577;P<0.001).The total satisfaction of the observation group was higher than that of the control group,and the difference was statistically significant(χ^(2)=7.585,P<0.05).There was no significant difference in the total incidence of complications between the two groups(χ^(2)=0.642,P>0.05).Conclusion:The breast protection combined with ALND in early breast cancer patients has better effect,less postoperative complications,quick recovery,less impact on shoulder mobility,which is conducive to improving the q

关 键 词：早期乳腺癌 经乳晕保乳术 改良根治术 腋窝淋巴结清扫 并发症 

分 类 号：R737.9[医药卫生—肿瘤]