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目的探讨保乳手术与改良根治术治疗早期乳腺癌的临床效果。方法选取2011年12月至2013年11月间江苏省徐州市肿瘤医院收治的90例早期乳腺癌患者,采用随机数字表法分为观察组和对照组,每组45例。观察组患者采用保乳手术,对照组患者采用改良根治术。对比两组患者围手术期指标、术后上肢淋巴水肿发生率、术侧上肢功能受限率、术后疼痛率及随访3年的并发症发生率、局部复发率、远处转移率、死亡率、乳腺癌生活质量量表(QLQ-BR23)评价结果。结果观察组患者手术时间及住院时间缩短,术中出血量较少,与对照组比较,差异有统计学意义(P<0.05)。观察组患者术后上肢淋巴水肿发生率、术侧上肢功能受限率及术后疼痛率较低,与对照组比较,差异有统计学意义(P<0.05)。观察组患者并发症发生率较低,与对照组比较,差异有统计学意义(P<0.05)。观察组患者局部复发率、远处转移率降低,与对照组比较,差异无统计学意义(P>0.05)。观察组患者社会、情绪、角色、躯体功能评分较高,与对照组比较,差异有统计学意义(P<0.05)。结论保乳手术的临床疗效显著,缩短了手术时间,对周围组织创伤小,随访期间并发症发生率较低。
Objective To investigate the clinical effect of conservative surgery and modified radical mastectomy on early breast cancer. Methods Ninety patients with early breast cancer who were admitted to Xuzhou Tumor Hospital of Jiangsu Province from December 2011 to November 2013 were randomly divided into observation group and control group with 45 cases in each group. Patients in the observation group were treated with breast-conserving surgery while those in the control group were treated with modified radical mastectomy. Comparing the perioperative indexes, the incidence of postoperative upper limb lymphedema, the function limitation rate of the upper extremity, the postoperative pain rate, the complication rate, the local recurrence rate, the distant metastasis rate, the mortality rate , Breast cancer quality of life scale (QLQ-BR23) evaluation results. Results In the observation group, the operation time and hospitalization time were shortened, and the amount of bleeding during operation was less. There was significant difference between the observation group and the control group (P <0.05). The incidence of postoperative upper extremity lymphedema in the observation group, the limited rate of upper limb function and the postoperative pain rate were lower in the observation group than those in the control group (P <0.05). The incidence of complication in observation group was lower than that in control group, the difference was statistically significant (P <0.05). The local recurrence rate and distant metastasis rate in the observation group were lower than those in the control group, but the difference was not statistically significant (P> 0.05). The score of social, emotional, role and physical function in observation group was higher than that in control group, and the difference was statistically significant (P <0.05). Conclusion The clinical efficacy of breast conserving surgery is significant, shortening the operation time, less trauma to the surrounding tissues and lower complication rate during follow-up.