Ⅰ～Ⅱ期乳腺癌保留乳头乳晕复合体并一期乳房重建术远期疗效的前瞻性随机对照研究

Prospective randomized controlled study of long-term efficacy of preserving nipple-areola combined with primary breast reconstruction for stage Ⅰ-Ⅱ breast cancer

目的早期乳腺癌患者实施保留乳头乳晕复合体联合一期乳房重建术进行治疗的临床疗效,改善患者预后。方法研究于2014年7月~2017年6月期间收集来我院就诊的80例早期乳腺癌患者参与,根据随机数字表法将其分为对照组和观察组,每组40例患者。对照组患者实施不保留乳头乳晕复合体联合常规乳腺癌改良根治术治疗,观察组患者实施保留乳头乳晕复合体改良根治术联合一期乳房重建术治疗。对比两组患者手术指标,术后复发和转移情况发生率,以及并发症发生率。同时通过乳腺癌患者生存质量量表对两组患者术后生活质量进行比较。结果观察组患者生活质量评分显著高于对照组,数据差异有统计学意义(P<0.05);两组患者创面引流量、引流时间、术后复发、转移以及并发症发生率等数据经比较差异无统计学意义(P>0.05)。结论早期乳腺癌患者实施保留乳头乳晕复合体联合一期乳房重建术可取得良好的临床疗效,可提升患者生活质量,获得良好的乳房美容效果,因此该种治疗方式值得在临床中进行推广。

Objective To evaluate the clinical outcomes of preserving nipple-areola combined with primary breast reconstruction for early breast cancer and improve their prognosis. Methods From July 2014 to June 2017, 80 patients with early breast cancer who were collected from our hospital were divided into a control group and an observation group, according to the random number table method, 40 patients in each group. In the control group, the patients were given non-retaining nipple-areola complexes with modified radical mastectomy. In the observation group, the patients were given preserving nipple-areola combined with primary breast reconstruction. The surgical index, incidence of recurrence and metastasis, and incidence of complications were compared between the two groups. At the same time, the postoperative quality of life of breast cancer patients was compared with quality of life scale. Results The scores of quality of life in the observation group were significantly higher than those in the control group, and the difference was statistically significant（P〈0.05）. There was no significant difference in wound drainage, drainage time, postoperative recurrence, metastasis, and complication rate between the two groups（P〈0.05）. Conclusion Preserving nipple-areola combined with primary breast reconstruction for early breast cancer patients can achieve good clinical efficacy, improve the quality of life of patients, and obtain good breast cosmetic results. Therefore, this treatment method is worthy of promotion in clinical practice.