乳腺癌改良根治术联合自体植皮术在乳腺癌手术治疗中的应用研究

Application of modified radical mastectomy combined with autologous skin grafting in operative treatment of breast cancer

目的探讨乳腺癌改良根治术联合自体植皮术在乳腺癌手术治疗中的应用研究。方法选取2013年3月至2015年5月86例乳腺癌患者,应用随机数字表法将其分为研究组和对照组,每组43例。对照组实施乳腺癌改良根治术,研究组实施乳腺癌改良根治术联合自体植皮术。对两组手术时间、住院时间、术后临床疗效(皮瓣坏死、二次植皮情况)、术后并发症发生率进行观察比较,同时对两组患者进行1年随访并观察1年复发情况。结果两组手术时间比较差异未见统计学意义(P>0.05),研究组住院时间较对照组显著缩短,差异有统计学意义(P<0.05);研究组皮瓣坏死及二次植皮术例数分别均较对照组显著增多,差异有统计学意义(P<0.05);术后研究组并发症总发生率较对照组显著降低,差异有统计学意义(P<0.05);治疗后1年两组患者均得到有效随访,其中研究组1年后无复发情况,对照组复发4例,研究组1年复发率较对照组显著降低(P<0.05)。结论乳腺癌改良根治术联合自体植皮术可有效降低乳腺癌手术治疗患者的皮瓣坏死及二次移植率,同时具有住院时间短、术后并发症发生率低、1年复发率低等优势,值得临床应用推广。

Objective To investigate the application of modified radical mastectomy combined with autologous skin grafting in operative treatment of breast cancer. Methods Eighty-six patients with breast cancer from March 2013 to May 2015 were randomly divided into study group and control group, with 43 cases in each group. The control group was treated by modified radical masteetomy, while the study group was treated by modified radical masteetomy combined with autologousskin grafting. The operation time, hospitalization time, postoperative clinical curative effects （flap necrosis, sec- ondary skin grafting） and the incidence of postoperative complications were observed and compared between the two groups. Both groups were followed up for 1 year and the l year recurrence was observed. Results There was no significant differ- ence in operation time between the two groups （ P 〉 0. 05 ）. The hospitalization time of the study group was significantly shor- ter than that of the control group （ P 〈 0. 05 ）. The number of cases with flap necrosis and secondary skin grafting in the study group were significantly larger than that in the control group （ P 〈 0.05 ）. The total incidence of postoperative eomplicationsin the study group was significantly lower than that in the control group （P 〈 0. 05 ）. One year after treatment, both groups were effectively followed up, and there was no recurreneeiu the study group, but there were 4 cases with recur- rence in the control group （ P 〈 0. 05 ）. Conclusion The applieationof modified radical masteetomy combined with autolo- gous skin grafting can effectively reduce skin flap necrosis and secondary skin grafting in patients undergoing breast cancer operation with short hospitalization time, low incidence of postoperativecomplications, and low recurrence rate within 1 year, etc. So it is worthy of clinical application.