乳腔镜下保留乳头切除术治疗早期乳腺癌对患者术后应激反应及并发症发生率的影响  

Effects of nipple-preservation mastectomy under breast endoscope on postoperative stress response and incidence of complications in patients with early breast cancer

作　　者：郭春根 李文伟 徐亮 GUO Chungen;LI Wenwei;XU Liang(Department of Breast Surgery,Nanchang People's Hospital,Nanchang,Jiangxi,330009,China)

机构地区：[1]南昌市人民医院乳腺外科,江西南昌330009

出　　处：《当代医学》2024年第24期20-23,共4页Contemporary Medicine

摘　　要：目的探讨乳腔镜下保留乳头切除术治疗早期乳腺癌(breast cancer,BC)对患者术后应激反应及并发症发生率的影响。方法选取2021年3月至2023年3月南昌市人民医院收治的86例早期BC患者作为研究对象,按照不同手术方式分为观察组(n=45)与对照组(n=41)。观察组采用乳腔镜下保留乳头切除术治疗,对照组采用传统BC根治性手术治疗,比较两组围手术期指标、应激反应、免疫功能(T淋巴细胞CD3^(+)、CD4^(+)、CD8^(+))水平、上肢功能恢复情况、术后乳房美观满意率及并发症发生率。结果观察组住院时间、手术时间均短于对照组,术中出血量少于对照组,差异有统计学意义(P<0.05)。术后,两组心率均慢于术前,舒张压、收缩压均低于术前,且观察组心率慢于对照组,舒张压、收缩压均低于对照组,差异有统计学意义(P<0.05)。术后,两组CD3^(+)、CD4^(+)水平均高于术前,CD8^(+)水平均低于术前,且观察组CD3^(+)、CD4^(+)水平高于对照组,CD8^(+)水平低于对照组,差异有统计学意义(P<0.05)。观察组术后乳房美观总满意率高于对照组,差异有统计学意义(P<0.05)。术后,两组上臂周径均长于术前,肩关节活动度均小于术前,但观察组上臂周径短于对照组,肩关节活动度大于对照组,差异有统计学意义(P<0.05)。观察组并发症发生率低于对照组,差异有统计学意义(P<0.05)。结论乳腔镜下保留乳头切除术治疗早期乳腺癌,能有效改善患者应激反应,且对免疫功能影响小,可增加乳房美观性,降低并发症发生率,值得临床推广应用。Objective To explore the effects of nipple-preservation mastectomy under breast endoscope on postoperative stress response and incidence of complications in patients with early breast cancer(BC).Methods A total of 86 patients with early BC admitted to Nanchang People's Hospital were enrolled between March 2021 and March 2023 were selected as the study subjects,they were divided into the observation group(n=45)and the control group(n=41)according to different surgical methods.The observation group was treated with nipple-preservation mastectomy under breast endoscope,while the control group was treated with traditional BC radical surgery.Perioperative indexes,stress response,immune function(T lymphocyte CD3^(+),CD4^(+),CD8^(+))levels,upper limb function recovery,postoperative breast aesthetic satisfaction rate and complication rate were compared between the two groups.Results The duration of hospitalization and operation in the observation group were shorter than those in the control group,and the intraoperalive blood loss was less than that in the control group,the difference were statistically significant(P<0.05).After surgery,the heart rate of the two groups were slower than before surgery,diastolic blood pressure and systolic blood pressure were lower than before surgery,and the heart rate in the observation group was slower than that in the control group,diastolic blood pressure and systolic blood pressure were lower than those in the control group,the differences were statistically significant(P<0.05).After surgery,CD3^(+)and CD4^(+)levels of the two groups were higher than before surgery,and CD8^(+)level was lower than before surgery,and CD3^(+)and CD4^(+)levels in the observation group were higher than those in the control group,while CD8^(+)level was lower than that in the control group,the differences were statistically significant(P<0.05).The total postoperative breast aesthetic satisfaction rate in the observation group was higher than that in the control group,and the difference was statistically sign

关 键 词：早期乳腺癌 乳腔镜 保留乳头切除术 术后应激反应 并发症发生率 

分 类 号：R73[医药卫生—肿瘤]