乳腔镜腋窝淋巴结清扫术与单纯腋窝淋巴结清扫术联合保乳术治疗早期乳腺癌患者的效果比较  

Comparison of effects of mastoscopic axillary lymph node dissection and single axillary lymph node dissection combined with breast-conserving surgery in treatment of patients with early breast cancer

作　　者：方建成 黄柏强 FANG Jiancheng;HUANG Baiqiang(nd Department of Surgery of Yanling County Hospital of Traditional Chinese Medicine,Xuchang 461200 Henan,China)

机构地区：[1]鄢陵县中医院外二科,河南许昌461200

出　　处：《中国民康医学》2025年第6期152-155,共4页Medical Journal of Chinese People’s Health

摘　　要：目的:比较乳腔镜腋窝淋巴结清扫术(MALND)与单纯腋窝淋巴结清扫术(ALND)联合保乳术治疗早期乳腺癌患者的效果。方法:回顾性分析2021年6月至2023年6月该院收治的96例早期乳腺癌患者的临床资料,根据手术方法不同将其分为观察组与对照组各48例。对照组行ALND联合保乳术治疗。观察组行MALND联合保乳术治疗。比较两组围手术期指标(术中出血量、手术时间、住院时间)水平,手术前后肩关节活动度(内收、外展、内旋、外旋、前屈、后伸)水平、生命质量[健康调查简表(SF-36)]评分,术后1个月乳房美观满意度和并发症发生率。结果:观察组术中出血量少于对照组,手术时间、住院时间均短于对照组,差异有统计学意义(P<0.05);术后,两组肩关节内旋、外旋、内收、外展、后伸、前屈活动度均小于术前,但观察组大于对照组,差异有统计学意义(P<0.05);术后,两组生理机能、生理职能、躯体疼痛、一般健康状况、精力、社会功能、情感职能及精神健康等SF-36评分均高于术前,且观察组高于对照组,差异有统计学意义(P<0.05);术后1个月,观察组乳房满意度为95.83%(46/48),高于对照组的83.33%(40/48),差异有统计学意义(P<0.05);观察组并发症发生率为8.33%(4/48),低于对照组的22.92%(11/48),差异有统计学意义(P<0.05)。结论:MALND联合保乳术治疗早期乳腺癌患者可减少术中出血量,缩短手术时间和住院时间,提高肩关节活动度水平、生命质量评分和乳房满意度,以及降低并发症发生率,效果优于ALND联合保乳术治疗。Objective:To compare effects of mastoscopic axillary lymph node dissection(MALND)and single axillary lymph node dissection(ALND)combined with breast-conserving surgery in treatment of patients with early breast cancer.Methods:The clinical data of 96 patients with early breast cancer admitted to this hospital from June 2021 to June 2023 were retrospectively analyzed.According to different surgical methods,they were divided into observation group and control group,48 cases in each group.The control group was treated with ALND combined with breast-conserving surgery,while the observation group was treated with MALND combined with breast-conserving surgery.The perioperative indexes(intraoperative blood loss,operation time,hospitalization time)levels,the shoulder joint range of motion(adduction,abduction,internal rotation,external rotation,flexion and extension)before and after the surgery,the quality of life[the MOS 36-item short form health survey(SF-36)]score,the breast aesthetic satisfaction,and the incidence of complications 1 month after the surgery were compared between the two groups.Results:The intraoperative blood loss in the observation group was less than that in the control group,the operation time and the hospitalization time were shorter than those in the control group,and the differences were statistically significant(P<0.05).After the surgery,the range of motion levels of internal rotation,external rotation,adduction,abduction,extension and flexion of shoulder joint in the two groups were smaller than those before the surgery,but those in the observation group were bigger than those in the control group,and the differences were statistically significant(P<0.05).After the surgery,the SF-36 scores of physiological function,physiological role,body pain,general health status,vitality,social function,emotional function and mental health in the two groups were higher than those before the surgery,those in the observation group were higher than those in the control group,and the differences were statisticall

关 键 词：乳腺癌 保乳术 乳腔镜 腋淋巴结清扫术 肩关节活动度 生命质量 并发症 

分 类 号：R737.9[医药卫生—肿瘤]