氟尿嘧啶植入剂在早期乳腺癌保乳术中的安全性研究

Safety study of fluorouracil implants for eraly breast cancer in breast-conserving surgery

目的探讨早期乳腺癌保乳术中应用氟尿嘧啶植入剂的临床安全性。方法将60例接受保乳术的早期乳腺癌患者随机分为植入剂组和对照组各30例,植入剂组行保乳术中应用氟尿嘧啶植入治疗,对照组行改良根治术治疗。观察2组术后并发症、切口拆线天数、手术时间、出血量、引流量等手术情况,血白细胞(WBC)、肝功能、肾功能等变化情况,并随访统计术后局部复发率、生存率。结果 2组术后并发症(切口感染裂开、皮下积液、患肢水肿)发生情况比较差异无统计学意义(P>0.05);植入剂组切口拆线天数、手术时间短于对照组,且出血量、引流量少于对照组,差异均有统计学意义(P<0.05)。2组手术后血WBC、ALT、Cr水平高于手术前,差异均有统计学意义(P<0.05);但2组间比较差异均无统计学意义(P>0.05)。植入剂组复发率、生存率分别为0、93.3%(28/30),对照组分别为3.3%(1/30)、90.0%(27/30),2组间比较差异均无统计学意义(P>0.05)。结论早期乳腺癌保乳术中植入氟脲嘧啶是安全、可靠的。

Objective To explore the clinical safety of fluorouracil implants for eraly breast cancer in breast-conserving surgery. Methods 60 cases of patients with early breast cancer undergoing breast conservative surgery were randomly divided into fluorouracil implants group and control group,each of 30 cases. The fluorouracil implants group was given fluorouracil implants during the breast-conserving surgery,while the control group was treated with modified radical mastectomy. So as to observe the postoperative complications,stitches days,operation time,bleeding amounts,volume of drainage,WBC,hepatic and renal function and census the recurrence and survival rate. Results The difference of postoperative complications （ infection of incisional wound dehiscence,subcutaneous effusion,limb edema ） were not significantly in 2 groups（ P〈0. 05） . The operation time,bleeding volume,wound drainage ,stitches days and other aspects of fluorouracil implant group was significantly less than those in the control group,the differences were statistically significant（ P〈0. 05） . Levels of WBC,glutamic-pyruvic transaminase（ ALT） ,and creatinine（ CREA） were significantly increased after operation compared with before operation,but there was no significant difference between the 2 groups （ P〈0. 05） . The recurrence and survival rate of the fluorouracil implants group were 0,93. 3% （ 28 /30） ,and which were 3. 3% （ 1 /30） 、90. 0% （ 27 /30） in the control group,so there were no significant differences between the 2 groups in recurrence and survival rate （ P〈0. 05） . Conclusion The method of implanting sustained-release fluorouracil for eraly breast cancer in breast-conserving surgery was safe.