保乳联合前哨淋巴结活检对老年乳腺癌患者的疗效及对术后生活质量及美容效果的影响

Breast-conserving United with Sentinel Lymph Node Biopsy for Elderly Patients with Breast Cancer and the Impact on Quality of Life after Surgery and Cosmetic Results

目的比较与分析保乳联合前哨淋巴结活检术与传统改良手术治疗老年乳腺癌患者的临床疗效及对患者术后生活质量、美容效果影响。方法 60例拟手术治疗的老年乳腺癌患者,按照手术治疗方法不同分为对照组与观察组,各30例。对照组采用传统改良手术治疗;观察组采用保乳联合前哨淋巴结活检术治疗。比较2组平均手术时间、术中平均出血量、总引流量、胸壁引流管拔管时间、并发症、治疗前后生活质量、术后美容效果,随访1~36个月,平均（22.5±1.2）个月。结果观察组平均手术时间为（64.7±24.5）min、术中平均出血量为（59.8±14.9）ml、拔管时间为（5.6±0.8）d、总引流量（102.7±20.9）ml明显少于对照组[平均手术时间为（101.2±22.3）min、术中平均出血量为（159.9±54.1）ml、拔管时间为（32.2±10.9）d、总引流量（264.1±17.1）ml],具有统计学意义,P〈0.05;观察组并发症2例,占6.7%,明显低于对照组（10例,占33.3%）,具有统计学意义,P〈0.05。2组治疗后各项生活质量均较术前明显改善,且观察组各项生活质量改善优于对照组,具有统计学意义,P〈0.05;观察组美容效果优于对照组,P〈0.05;但随访期间死亡和复发及转移率与对照组比较,P〉0.05。结论相比传统手术治疗来说,保乳联合前哨淋巴结活检术较为简单,减少并发症发生,促进患者术后康复,且术后美容效果好,从而提高患者生活质量。

Objective To compare and study the clinical efficacy of breast-conserving surgery combined with sentinel lymph node biopsy and traditional surgical treatment for elderly patients with breast cancer,and effect on quality of life and cosmetic effect. Methods 60 cases of elderly breast cancer patients who proposed surgery,according to the surgical treatment,were divided into the control group and the observation group,30 cases in each. The control group received traditional surgery; the observation group received breast-conserving therapy combined with sentinel lymph node biopsy. Operative time,intraoperative blood loss average total drainage,chest drainage tube extubation time,complications,quality of life before and after treatment,cosmetic results after surgery were compared,followed up was 1 to 36 months（ mean 22. 5 ± 1. 2 months）. Results In the observation group,the mean operative time was（ 64. 7 ± 24. 5） min,mean intraoperative blood loss was（ 59. 8 ± 14. 9） ml,extubation time was（ 5. 6 ± 0. 8） d,total drainage volume was（ 102. 7 ± 20. 9） ml,which were significantly less than those of the control group,the mean operative time was（ 101. 2 ± 22. 3） min,mean intraoperative blood loss was（ 159. 9 ± 54. 1） ml,extubation time was（ 32. 2 ± 10. 9） d,total drainage volume was（ 264. 1 ± 17. 1） ml,there had statistical significance,P〈0. 05; complications in the observation group had 2 cases（ 6. 7%）,which was significantly lower than 10 cases in the control group,33. 3%,there had statistical significance,P〈0. 05. Quality of life after treatment significantly improved than before treatment,and the observation group was better than the control group,there had statistical significance,P〈0. 05; Observation group had better cosmetic effect than the control group,P〈0. 05; but death,recurrence and metastasis rate during follow-up compared with the control group,P〉0. 05.Conclusion Compared with traditional surgery,the clinical application of sentinel lymph node biopsy in breast-conserving sur gery is relatively simple,it can reduce complications,promote the rehabilitation of patients after surgery,with good cosmetic results,and improve the quality of life of patients.