绝经期早期乳腺癌患者根治术中留取乳头乳晕联合假体植入的效果及生存质量、并发症观发生率探讨分析

Study and Analysis of Effect of Nipple-areola Preservation and Prosthesis Implantation in Radical Operation of Patients with Early Breast Cancer during the Menopause Period and Survival Quality and Incidence Rate of Complications

目的探讨保留乳头乳晕的改良根治术联合假体置入术对早期乳腺癌患者乳房重建的意义,并观察其生存质量、并发症。方法方便选取2014年9月—2016年9月该院收治的128例绝经期早期乳腺癌患者,其中118例为Ⅰ期患者,10例为Ⅱ期患者。按照手术方法的不同分为观察组(50例)和对照组(78例),观察组行保留乳头乳晕的改良根治术联合假体即刻置入术,对照组行传统改良根治术。术后3个月对乳房外观、生活质量以及术后并发症的情况进行评价。结果术后3个月对两组患者的乳房外观评价结果:观察组患者的乳房外观优良率达96.00%显著高于对照组的乳房外观优良率为66.67%,差异有统计学意义(χ~2=14.90,P<0.05)。3个月后的两组患者生活质量评分结果显示:观察组为(156.43±21.95)分显著高于对照组(101.32±20.53)分,差异有统计学意义(χ~2=11.567,P<0.05)。术后并发症数据结果:观察组的术后皮瓣坏死、创面渗液、淋巴水肿的发生率分别为12.00%、34.00%、2.00%,对照组的术后皮瓣坏死、创面渗液、淋巴水肿的发生率分别为11.54%、42.31%、3.85%,两组数据的统计学分析结果显示,两组的并发症发生率差异无统计学意义(χ~2=1.358,P>0.05)。结论保留乳头乳晕改良根治术联合假体置入术在临床治疗绝经期早期乳腺癌患者中的应用时有显著的临床效果,且患者的临床获益大大提高,值得推广使用。

Objective To discuss the significance of modified radical operation preserving the nipple-areola and prosthesis implantation surgery on the breast reconstruction of patients with early breast cancer and observe their survival qualities and complications. Methods 128 cases of patents with early breast cancer during the menopause period admitted and treated in our hospital from September 2014 to September 2016 were conveniently selected including 118 cases of patients during Ⅰstage and 10 cases of patients during Ⅱ stage, and the patients were divided into two groups according to different operation methods, the observation group with 50 cases adopted the modified radical operation preserving the nipple-areola and prosthesis implantation surgery, while the control group with 78 cases adopted the traditional modified radical operation, and the breast appearance, quality of life and postoperative complications situation were evaluated in 3 months after operation.Results The excellent and good rate of beast appearance in the observation group was obviously higher than that in the control group（96.00% vs 66.67%）, and the difference was statistically significant（χ^2=14.90,P〈0.05）, the quality of life score in the observation group was obviously higher than that in the control group [（156.43±21.95）points vs（101.32±20.53）points],and the difference was statistically significant（χ^2=11.567,P〈0.05）, and the differences in the incidence rates of complications such as postoperative skin flap necrosis, wound exudate and lymphedema between the observation group and the control group were not statistically significant（12.00%,34.00%,2.00% vs 11.54%,42.31%,3.85%）（χ^2=1.358,P〈0.05）. Conclusion The application effect of modified radical operation preserving the nipple-areola and prosthesis implantation surgery in clinical treatment of patients with early breast cancer is obvious, which can greatly improve the clinical benefits, and it is worth promotion and application.