两种乳腔镜腋窝淋巴结清扫术治疗乳腺癌的临床观察

Clinical observation of two kinds of endoscopic axillary lymph node dissection for breast cancer

目的探讨两种腔镜腋窝淋巴结清扫术(MALND)治疗乳腺癌的近、远期临床效果。方法选取2019年9月至2021年12月收治的108例乳腺癌患者作为研究对象,采用随机数字表法将患者分为溶脂组和非溶脂组,每组各54例。溶脂组采用溶脂充气法行MALND,非溶脂组采用非溶脂充气法行MALND。应用软件SPSS 22.0处理数据,围手术期相关指标等计量资料采用(x^(-)±s)表示,行独立样本t检验;术后并发症等计数资料采用[例(%)]表示,行χ^(2)检验;生存分析采用Kaplan-Meier法并行Log-Rank检验。P<0.05表示差异有统计学意义。结果非溶脂组手术时间显著高于溶脂组(P<0.05);两组患者术中出血量、淋巴结清扫数目、术后引流量及术后住院时间比较,差异无统计学意义(P>0.05)。两组患者术后并发症总发生率比较(16.7%vs.11.1%),差异无统计学意义(P>0.05)。非溶脂组患者累积无病生存率显著高于溶脂组(94.4%vs.83.3%),差异有统计学意义(Log-Rankχ^(2)=3.899,P=0.048)。结论溶脂充气法MALND与非溶脂充气法MALND均是安全可行的,非溶脂充气法MALND虽然手术时间略有延长,但并未增加手术风险,且有利于改善患者预后,值得临床推广应用。

Objective To investigate the short-term and long-term clinical effects of two kinds of endoscopic axillary lymph node dissection(MALND)for breast cancer.Methods A total of 108 patients with breast cancer admitted from September 2019 to December 2021 were selected as research objects.The patients were divided into lipid soluble group and non-lipid soluble group by random number table method,with 54 patients in each group.The fat soluble group was administered MALND by the fat soluble aeration method,and the non-fat soluble group was administered MALND by the non-fat soluble aeration method.SPSS 22.0 was used to process the data.Measurement data such as perioperative indicators were represented by(x^(-)±s)and independent sample t test was performed.Counting data such as postoperative complications were represented by[cases(%)],andχ^(2)tests were performed.Survival analysis was performed by Kaplan-Meier method and Log-Rank test.P<0.05 indicated statistically significant difference.Results The operation time of non-soluble lipid group was significantly higher than that of soluble lipid group(P<0.05).There was no significant difference in intraoperative blood loss,number of lymph node dissection,postoperative drainage volume and postoperative hospital stay between the two groups(P>0.05).There was no significant difference in the total incidence of postoperative complications between the two groups(16.7%vs.11.1%)(P>0.05).The cumulative disease-free survival rate in non-soluble group was significantly higher than that in soluble group(94.4%vs.83.3%),and the difference was statistically significant(Log-Rankχ^(2)=3.899,P=0.048).Conclusion Both MALND and MALND are safe and feasible.Although the operation time of MALND is slightly prolonged,the non-soluble method does not increase the risk of operation,and is beneficial to improve the prognosis of patients,which is worthy of clinical promotion and application.