弧形切口保乳术治疗乳腺癌患者的效果分析

梅小强 ¹ ,陈秀春 ² ,郭旭辉 ² ,李利飞 ¹

(1.新密市中医院普外二科,河南 新密 452370;2.河南省肿瘤医院乳腺科,河南 郑州 450000)

摘要 目的:分析弧形切口保乳术治疗乳腺癌患者的效果。 方法:选取 83 例乳腺癌患者,依照手术方法不同分为两组。 对照组 41 例,接受放射切口保乳术治疗,观察组 42 例,接受弧形切口保乳术治疗,比较两组治疗效果。 结果:两组切口长度、手术时间比较,均无统计学差异(P>0.05);观察组术中失血量较对照组少(P<0.05);观察组美容优良率 92.86%高于对照组 73.17%(P<0.05);两组切口感染、瘀斑、血肿发生率比较,均无统计学差异(P>0.05);两组术后 1 年转移率、复发率比较,均无统计学差异(P>0.05);术后 6 个月、1 年,两组生存质量均得到提升,且观察组 FACT-B 评分较对照组高(P<0.05)。 结论:弧形切口保乳术治疗乳腺癌,美容效果显著,并能减少术中失血量,提高生存质量,安全性较高。

关键词: 弧形切口;放射切口;保乳术;乳腺癌;美容

中图分类号:R737.9 文献标志码:A 文章编号:1008-2409(2022)03-0077-04

Efficacy of breast-conserving surgery by arcuate incision in patients with breast cancer 

MEI Xiaoqiang ¹ , CHEN Xiuchun ² , GUO Xuhui ² , LI Lifei ¹ .(1. The 2 nd Department of General Surgery, Xinmi Hospital of Traditional Chinese Medicine, Xinmi 452370; 2. Dept. of Galactophore, Henan Cancer Hospital, Zhengzhou 450000, China)

Abstract Objective: To analyze the effect of breast-conserving surgery by arcuate incision on patients with breast cancer. Methods: 83 breast cancer patients were divided into two groups according to different surgical methods. 41 cases in the control group received breast-conserving surgery by radiation incision, while another 42 cases in the observation group were treated with breast-conserving surgery by arc incision, and the therapeutic effects were compared between the two groups. Results: There were no significant difference in the length of incision and operation time between the two groups(P>0.05), and the blood loss during the operation in the observation group was less than that in the control group(P<0.05); the excellent and good rate of beauty in the observation group was 92.86% the observation group, higher than 73.17% in the control group(P<0.05); there was no significant difference in the incidence of incision infection, ecchymosis, and hematoma between the two groups(P>0.05); there was no significant difference in the metastasis rate and recurrence rate in both groups one year after surgery(P>0.05); and 6 months and one year after surgery, the quality of life of patients in both groups were improved, and the FACT-B scores of the observation group were higher than those of the control group(P<0.05). Conclusion: Breast-conserving surgery by arcuate incision has a significant cosmetic effect for patients with breast cancer, and it can reduce intraoperative blood loss and improve the quality of life without increasing the risk of complications, recurrence and metastasis.

Keywords: arcuate incision; radiation incision; breast conserving surgery; breast cancer; beauty

参考文献:

[1] 张璐璐,刘芸,段文冰,等.乳腺癌患者部分外周血指标的变化及肿瘤标志物的诊断价值[J]. 中国医药,2018,13(3):421-425.

[2] JONCZYK M M,JEAN J,GRAHAM R,et al.Surgical trends in breast cancer:a rise in novel operative treatment options over a 12 year analysis[J].Breast Cancer Res Treat,2019,173(2):267-274.

[3] 赵兴娟,杨璇.不同切口保乳术对乳腺癌患者美容效果和预后的影响[J].中国基层医药,2019,26(22):2732-2735.

[4] MATTHIES L M,TARAN F A,KEILMANN L,et al. An electronic patient-reported outcome tool for the FACT-B (Functional Assessment of Cancer Therapy-Breast) questionnaire for measuring the health-related quality of life in patients with breast cancer: reliability study [ J]. J Med Internet Res,2019,21(1):e10004.

[5] 邵志敏.乳腺癌保乳手术的进展与评述[J].肿瘤防治研究,2018,45(5):269-273.

[6] 陈亚,张强,刘铁成.保乳术———乳腺癌外科治疗的发展方向[J].安徽医学,2017,38(2):246-249.

[7] 黄铁碧,张进杰,赵李业.保乳术和改良的乳腺癌根治术治疗乳腺癌的临床对照研究[J].中国医药科学,2019,9(6):222-224,254.

[8] 王展海,邢海军.不同切口保乳术治疗乳腺癌的疗效和美容效果评价[J].中国急救医学,2017,37(z1):272-273.

[9] DAAR D A,ABDOU S A,ROSARIO L,et al.Is there a preferred incision location for nipple-sparing mastectomy a systematic review and meta-analysis[J].Plast Reconstr Surg,2019,143(5):906e-919e.

[10] PARK J W,SEONG I H,LIM W,et al.Pure hemi-periareolar incision versus conventional lateral radial incision mastectomy and direct-to-implant breast reconstructions:comparison of indocyanine green angiographic perfusion and necrosis of the nipple[J].Gland Surg,2020,9(5):1193-1204.

[11] 唐巍,龙梅,文桂琼.乳晕弧形切口和乳房放射状切口切除乳腺纤维瘤的疗效比较研究[J].中国肿瘤外科杂志,2017,9(3):191-192,196.

[12] 康乐平,李俊川,邹正东.不同切口对乳腺癌患者保乳术后胸部美容效果及身心状态的影响[J].中国美容医学,2019,28(3):34-36.

[13] 周大鹏.环乳晕切口与传统放射状切口手术治疗乳腺纤维腺瘤的临床观察[J].临床医学研究与实践,2017,2(17):79-80.

[14] 阿依努尔,阿力比亚提·艾尼.早期乳腺癌患者保乳术联合术后放疗与乳房全切术的疗效对比[J].现代肿瘤医学,2022,30(9):1608-1613.

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