乳腺癌改良根治术46例临床分析

Clinical analysis of modified radical mastectomy in 46 cases with breast cancen

目的:总结Ⅰ、Ⅱ期乳腺癌的外科治疗经验,探讨乳腺癌改良根治术的临床疗效。方法:回顾性分析46例乳腺癌施行保留胸大小肌的改良根治术的治疗效果。结果:46例患者中术后发生皮缘坏死6例(13.04%),皮下积液4例(8.7%),上肢淋巴性水肿1例(2.17%),胸肌挛缩伴同侧上臂运动障碍1例(2.17%),术后辅助化疗和放疗,3年生存率81%,5年生存率62%。结论:采用改良根治术治疗Ⅰ、Ⅱ期乳腺癌,术中应规范操作和正确处理,应对胸大肌血液供应血管及支配其运动的神经加强保护,以提高病人术后生存质量。术后早期化疗、放疗及综合治疗可以减少并发症,预防复发和转移,提高远期疗效和生存率。

Objective： To summarize surgical therapy experience about stage Ⅰ , Ⅱ breast carcinoma, and its clinical curative effect. Method： To retrospectively analyze curative effect on 46 cases with breast carcinoma by performing modified radical mastectomy or reserve pectoralis major and pectoralis minor. Result： Among all 46 cases, after operation, 6 cases complicated cortex necrosis （13.04%）, 4 cases complicated subcutaeous hydrops（8.7%）, 1 case complicated upper extremity lymph edema（2.17%）, and 1 case pectoralis muscles contracture cornpanied with limp movement disorders（2.17%）, adjuvant chemotherapy and radiotherapy were done, 3 year survival rate：81%, and 5 year survival rate： 62%. Conclusion： Adopting modified radical mastectomy to treat stage Ⅰ , Ⅱ breast carcinoma, in the course of operation, surgeon should be normal manipulate and correct handle, protect blood vessel of pectoralis major or nerves of control movement, by this means, to improve life quality of patients. After operation, earlier chemotherapy, radiotherapy and combined modality therapy can decrease complicated symptom and prevent relapse or metastasis, raise prostective efficacy and survival rate.