保乳术联合辅助化疗治疗乳腺癌的临床疗效分析

Clinical efficacy of breast conserving surgery combined with adjuvant chemotherapy in treatment of breast cancer

目的分析保乳术联合辅助化疗对乳腺癌患者的临床疗效和不良反应。方法选择88例患有Ⅰ~Ⅱ期乳腺癌的患者作为研究对象,随机分为观察组和对照组,每组44例。所有患者均采用表柔比星联合多西他赛新辅助化疗方案。其中观察组患者采用辅助腔镜乳腺癌保乳术治疗,对照组患者采用传统保乳术进行治疗。对比分析2组患者手术的效果、2年生存率、复发率、化疗的不良反应。同时对手术时间、平均引流量、术中出血量、术中淋巴结的清除数目及引流管拔管时间进行记录。结果观察组患者有1例死亡,2例复发,对照组有3例死亡,4例复发,2组死亡率和复发率差异无统计学意义。观察组患者的乳房美容优良率明显高于对照组（P〈0.05）;观察组患者的手术时长、拔管时间、插管引流量均明显低于对照组（P〈0.05）,但2组淋巴结清扫数目差异无统计学意义。2组患者均出现了不同程度的不良反应,但观察组患者不良反应率明显低于对照组（χ2=8.25,P〈0.05）。结论采用腔镜进行乳腺癌保乳术的辅助治疗,联合药物化疗具有较好的临床治疗效果,机体所受损伤较小,不良反应较少且可耐受。

Objective To analyze the breast conserving surgery combined with adjuvant chemotherapy on the clinical efficacy and adverse reactions during the treatment of patients with breast cancer. Methods 88 cases with Ⅰ-Ⅱ breast cancer from August 2010 to August 2010 were randomly divided into observation group（n = 44） and control group according to the different treatment（n = 44）. All the patients were treated with epirubicin and docetaxel （TE） neoadjuvant chemotherapy. Which observation group were treated by video-assisted breast cancer breast conserving surgery, and patients in the control group using traditional breast conserving surgery treatment, two groups of patients were soft than stars and docetaxel （TE） combination therapy. The adverse reaction of the two groups were compared and analyzed the effect of the operation, 2 years survival rate, recurrence rate, chemotherapy. At the same time, operation time, average bleeding volume, drainage volume, intraoperative lymph node clearance and drainage tube extubation time were recorded. Results Observation group were 1 cases of death, 2 cases of recurrence, while the control group had 3 cases died, 4 cases of recurrence, the mortality and recurrence rate in two groups after statistical analysis has no significant difference, the observation group of patients with breast cosmetic was significantly higher than the control group; the observation group of patients with operation tirae and extubation time were significantly shorter than the control group, （ P 〈 0. 05 ）. The observation group of patients with intubation drainage was significantly lower than the control group, after statistical analysis, with significant difference （ P 〈 0.05 ）, but the two group number of resected lymph nodes after statistical analysis, there was no significant difference ; the two groups had different degrees of adverse reactions, which observation group in patients with hair loss, vomiting, and patients in the control group appeared in the hair loss, nausea and vomiting, the neutral granular cell reduction, decrease in hemoglobin, thrombocytopenia and cardiac toxicity and other adverse reactions,the adverse reaction rate of experiment group was lower than control group（χ^2 = 8. 25, P 〈 0. 05 ）. Conclusion Endoscopic breast cancer breast conserving surgery adjuvant therapy and combination chemotherapy has better clinical curative effect, less damage to the body, less adverse reaction and tolerable.