保乳手术与改良根治术对早期乳腺癌患者的临床疗效及生活质量的影响

Effect comparison of breast conserving surgery and modified radical mastectomy on quality of life in patients with breast cancer

目的对比保乳手术与改良根治术对早期乳腺癌患者的临床疗效及生活质量的影响。方法选择2014年3月至2016年3月北京市密云区医院收治的80例早期乳腺癌患者,随机分为两组,各40例,观察组采用保乳手术治疗,改良组采用改良根治术治疗,术后对比两组疗效与生活质量。结果观察组术后1个月、6个月生理状况、情感状况、社会状况、功能状况、其他因素、生活质量综合评分均显著高于改良组,且差异均有统计学意义(t1=5.538、6.387、5.356、6.573、7.028、9.109;P1=0.020、0.016、0.022、0.012、0.009、0.000;t2=5.037、7.326、6.192、6.246、7.186、8.038;P2=0.025、0.004、0.014、0.017、0.007、0.000);观察组术后乳房美观优良率显著高于改良组,差异有统计学意义(95.0%vs 0,X^2=11.039,P=0.000);术后观察组HAMA评分为(12.6±2.3),HRDS评分为(11.4±2.2),均显著低于改良组,差异有统计学意义(t=9.289、8.930,P=0.000、0.000);两组在2年生存率、远处转移率及局部复发率方面对比差异无统计学意义(X^2=0.726、0.927、0.639,P=0.302、0.101、0.592)。结论早期乳腺癌患者采用保乳手术治疗能够保障乳房美观度,显著提高生活质量,改善心理状态,疗效确切,值得临床推广采用。

Objective To explore the correlation of breast conserving surgery and modified radical mastectomy for early breast cancer patients with clinical efficacy and quality of life.Methods Eighty cases of early breast cancer from March 2014 to March 2016 in Beijing Miyun District Hospital were randomly divided into two groups. Observation group were treated with breast conserving surgery, and the control group underwent the modified radical mastectomy. The efficacy and quality of life were compared of two groups after the operation.Results The data such as physiological status, emotional status, social status, functional status and other factors of the observation group after 1 month and 6 months were respectively significantly higher than the control group with statistical differences （t1=5.538, 6.387, 5.356, 6.573, 7.028, 9.109,P1=0.020, 0.016, 0.022, 0.012, 0.009, 0.000;t2=5.037, 7.326, 6.192, 6.246, 7.186, 8.038,P2=0.025, 0.004, 0.014, 0.017, 0.007, 0.000）. The postoperative breast appearance excellent rate of observation group was higher than that of the control group, with statistical differences （95.0%vs 0,χ2=11.039,P=0.000）; postoperative HAMA score and HRDS score of observation group were significantly lower than the control group, with significant differences （t=9.289, 8.930,P=0.000, 0.000）. The two groups had no significant differences in the 2-year survival rate, distant metastasis rate and local recurrence rate （χ2=0.726, 0.927, 0.639,P=0.302, 0.101, 0.592）.Conclusion It can guarantee the appearance of the breast, significantly improve the quality of life, and improve the psychological state for early breast cancer patients undergoing breast conserving surgery with curative effect.