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目的:探讨前哨淋巴结活检术的学习曲线。方法:选取2011年3月—2012年10月行乳腺癌改良根治术的60例早期浸润性乳腺癌患者作为研究对象,按照手术时间的先后顺序分别为A,B,C组,每组20例,所有研究对象在进行改良根治术前先行腋窝前哨淋巴结活检,比较各组的手术时间、前哨淋巴结活检成功率、假阴性率及灵敏度。结果:A,B,C组手术时间分别为(36.6±8.2)min,(25.1±7.4)min,(17.3±5.6)min,各组间差异有统计学意义(P<0.05)。A组前哨淋巴结活检的成功率为65.0%,假阴性率为55.6%,灵敏度为44.4%;B组分别为95.0%,11.1%,88.9%;C组分别为100.0%,0,100.0%;各组间差异均有统计学意义(均P<0.05)。结论:在规范化地进行20例前哨淋巴结活检术后,即可基本掌握前哨淋巴结活检术的手术技术;经过40例的手术实践后,可以达到较为熟练的程度。
Objective: To investigate the learning curve of sentinel lymph node biopsy. Methods: Sixty patients with early invasive breast cancer who underwent modified radical mastectomy from March 2011 to October 2012 were selected as the study group, and were divided into groups A, B and C according to the order of operation time, with 20 cases in each group . All subjects underwent axillary sentinel lymph node biopsy prior to modified radical mastectomy. The operative time, sentinel lymph node biopsy success rate, false negative rate and sensitivity were compared between groups. Results: The operation time in group A, B and C were (36.6 ± 8.2) min and (25.1 ± 7.4) min and (17.3 ± 5.6) min, respectively. There was significant difference between the groups (P <0.05). In group A, the success rate of sentinel lymph node biopsy was 65.0%, the false negative rate was 55.6% and the sensitivity was 44.4%; in group B 95.0%, 11.1% and 88.9% respectively; in group C 100.0% and 0 100.0% The differences were statistically significant (all P <0.05). CONCLUSION: After the standardization of 20 cases of sentinel lymph node biopsy, we can basically grasp the surgical technique of sentinel lymph node biopsy. After 40 cases of surgical practice, we can reach a more proficient level.