论文部分内容阅读
目的探讨肿胀液溶脂法直视下乳腺癌腋窝淋巴结清扫术的临床效果。方法选择2009年12月—2011年9月在上海市第一人民医院宝山分院乳腺外科住院的乳腺癌患者60例,均为女性,按手术方式分为溶脂组30例和传统组30例,分别行肿胀液溶脂法直视下腋窝淋巴结清扫及传统手术,记录术中情况、淋巴结转移率、术后并发症、创面冲洗液脱落细胞学镜检及随访结果。结果两组患者术中情况比较,溶脂组患者的腋窝淋巴结清扫时间较传统组短〔(25.1±2.2)min和(35.2±6.1)min〕,术中出血量较传统组少〔(76.4±26.4)ml和(140.2±56.4)ml〕,差异有统计学意义(t值分别为2.410、7.175,P<0.05)。溶脂组和传统组患者的淋巴结转移率(42/696,47/720)间差异无统计学意义(χ2=0.129,P=0.720)。溶脂组患者术后前臂内侧麻木疼痛发生率少于传统组(6/30和18/30),差异有统计学意义(χ2=10.000,P<0.05)。创面冲洗液脱落细胞学镜检溶脂组未发现阳性病例、传统组发现1例,差异无统计学意义(χ2=1.017,P=0.313)。经1年随访,两组患者均未发现局部复发、切口种植和远处转移。结论肿胀液溶脂法可以清晰暴露乳腺癌患者腋窝血管、神经和淋巴结,直视下行腋窝淋巴结清扫术简单易行,对于保护肋间臂神经、减少术后并发症有重要意义。
Objective To investigate the clinical effect of axillary lymph node dissection in breast cancer with swollen solution lipolysis. Methods Sixty patients with breast cancer who were hospitalized in Department of Breast Surgery, Baoshan Branch of Shanghai First People’s Hospital from December 2009 to September 2011 were women. They were divided into three groups according to the operation: The patients underwent axillary lymph node dissection and traditional surgery under direct vision by swollen solution lipolysis. The intraoperative status, lymph node metastasis rate, postoperative complications, exfoliative cytology and follow-up results were recorded. Results Compared with the traditional group, the time of axillary lymph node dissection in the lipolipid group was shorter than that in the traditional group [(25.1 ± 2.2) min and (35.2 ± 6.1) min) 26.4) ml and (140.2 ± 56.4) ml, respectively, the difference was statistically significant (t = 2.410, 7.175, P <0.05). There was no significant difference in lymph node metastasis between fat-soluble group and traditional group (χ2 = 0.129, P = 0.720) (42/696, 47/720). The incidence of numbness pain in the medial forearm forearm in the lipolysis group was less than that in the traditional group (χ2 = 10.000, P <0.05). In the traditional group, one case was found, but the difference was not statistically significant (χ2 = 1.017, P = 0.313). After 1 year follow-up, no recurrence, incision implantation and distant metastasis were found in both groups. Conclusion The swelling liquid lipolipid method can clearly expose the axillary vessels, nerves and lymph nodes of patients with breast cancer. Direct descending axillary lymph node dissection is simple and easy, which is of great significance for the protection of intercostobrachial nerve and reduction of postoperative complications.