早期乳腺癌根治术与保乳手术的临床疗效观察

Efficacy of radical mastectomy versus breast conserving surgery for early breast cancer

目的探讨早期乳腺癌根治术与保乳手术的临床治疗效果。方法选择2014年5月至2015年5月间海南省临高县人民医院收治的68例早期乳腺癌患者,采用随机数字表法分为保乳组和根治组,每组34例。根治组患者采用早期乳腺癌根治术,保乳组患者采用早期保乳手术治疗。结果保乳组患者手术时间(165.5±2.6)min、出血量(260.5±20.5)ml、切口长度(4.5士1.2)cm、住院时间(9.3±2.2)d,均低于根治组患者的(185.6士4.5)min、(284.6±30.5)ml、(15.3±2.8)cm和(13.4±2.5)d,差异均有统计学意义(均P<0.05)。保乳组患者术后美容的优良率88.2%高于根治组患者的67.7%,差异有统计学意义(均P<0.05)。保乳组患者的情感状况(17.5±1.5)分、生理状况(18.8±1.5)分、功能状况(18.6士1.5)分、附加条目(21.6±1.3)分和生活质量总分(96.5±4.6)分,均高于根治组患者的(14.0±1.5)分、(14.5±1.6)分、(12.4±1.6)分、(17.5±1.2)分和(77.8±6.5)分,差异均有统计学意义(均P<0.05)。保乳组患者术后1年局部复发率为5.9%,根治组患者为2.9%,差异无统计学意义(P>0.05)。结论与早期乳腺癌根治术相比,保乳手术治疗早期乳腺癌具有更理想的手术指标和恢复速度,提高了美观度与生活质量,且近期复发率相当,适于临床应用。

Objective To explore the clinical efficacy of radical mastectomy versus breast conserving surgery for early breast cancer.Methods Select 68 patients with early stage breast cancer who were admitted to Lingao People＇s Hospital from May 2014 to May 2015 divided into radical mastectomy group and breast conserving group,with 34 patients in each group.Results The operation time,blood loss,incision length and length of stay in the breast conserving group（165.5 ±2.6 min,260.5 ±20.5 ml,4.5 ± 1.2 cm and 9.3 ±2.2 d,respectively） were lower than the radical mastectomy group（185.6 ±4.5 min,284.6 ±30.5 ml,15.3 ±2.8 cm and 13.4 ±2.5 d,respectively）（all P〈0.05）.The good plastic surgery rate in the breast conserving group was 88.2% which was higher than 67.7% of the control group（P〈0.05）.The emotional state,physiological status,functional status,additional items and the overall quality of life score were higher in the breast conserving group（17.5 ±1.5,18.8 ±1.5,18.6 ±1.5,21.6 ± 1.3 and 96.5 ±4.6,respectively） than the radical cure group（14.0 ± 1.5,14.5 ± 1.6,12.4 ± 1.6,17.5 ± 1.2 and 77.8 ± 6.5）（all P〈0.05）.There was no significant difference in local recurrence rate between the breast conserving,respectively group（5.9%） and the radical mastectomy group（2.9%） at 1 year after the surgery（P〉0.05）.Conclusion Compared with radical mastectomy,breast conserving surgery has better indexes and recovery rate for early breast cancer surgery.It improves the quality of life and beauty and has comparative short-term recurrence,which is appropriate for clinical application.