传统保乳根治术与乳腺切除并腋窝淋巴结清扫术的疗效对比观察

Comparison of Curative Effects between Traditional Breast-conserving Radical Mastectomy and Mastectomy and Axillary Lymph Node Dissection

目的探讨传统保乳根治术与乳腺切除并腋窝淋巴结清扫术的疗效对比。方法调取2016年10月—2017年9月该科室诊治的110例乳腺癌手术患者资料,对照组采取传统保乳根手术治疗方法,观察组采用乳腺切除并腋窝淋巴结清扫术,观察2组手术情况、住院时长、术后生活质量评分以及上肢感觉异常和淋巴水肿情况的对比。结果观察组患者的手术时长、切口长度、术中出血量、住院时长分别为(58.93±13.25)min、(4.02±1.15)cm、(10.11±2.87)m L、(10.74±2.17)d,对照组分别为(95.72±26.78)min、(11.87±2.44)cm、(85.27±14.28)m L、(15.86±4.43)d,差异有统计学意义(t=9.13、21.58、5.71、7.69,P<0.05)。观察组上肢感觉异常与淋巴水肿患者分别有10例(占18.18%),6例(占10.91%);对照组的上肢感觉异常与淋巴水肿患者分别有21例(占38.18%),23例(占48.81%);2组相较而言,观察组上肢感觉异常与淋巴水肿发生率均较低(χ~2=5.393,4.398,P<0.05)。术后3个月,观察组环境、生理、心理、社会功能评分分别为(78.17±10.54)分、(65.69±9.11)分、(68.31±7.33)分、(68.77±7.15)分,对照组分别为(68.45±7.68)分、(54.18±6.28)分、(59.27±5.82)分、(57.46±5.97)分,观察组显著高于对照组,差异有统计学意义(t=7.49、3.59、4.76、6.02,P<0.05)。结论采取乳腺切除并腋窝淋巴结清扫术,可以有效清除癌细胞,减少术后上肢感觉异常与淋巴水肿情况,加快身体机能康复,缩短临床住院时间,提升患者生活质量,因此,可以在大力实践与推广。

Objective To compare the curative effect of traditional breast-conserving radical mastectomy with mastectomy and axillary lymph node dissection. Methods Data from 110 breast cancer patients treated in the department from October 2016 to September 2017 were collected. The control group was treated with traditional breast-conserving root surgery. The observation group was treated with mastectomy and axillary lymph node dissection. The two groups were observed of situation, duration of hospital stay, postoperative quality of life score, and comparison of upper limb paresthesia and lymphedema. Results The length of operation, incision length, intraoperative blood loss, length of hospital stay in the observation group were（58.93±13.25）min,（4.02±1.15）cm,（10.11±2.87）mL, and（10.74±2.17）d, respectively.The differences were statistically significant at（95.72±26.78）min,（11.87±2.44）cm,（85.27±14.28）mL, and（15.86±4.43）d（t=9.13, 21.58, 5.71,7.69, P〈0.05）. In the observation group, there were 10 cases（18.18%） and 6 cases（10.91%） of upper limb paresthesia and lymphedema, respectively; in the control group, there were 21 cases（38.18%） and 23 cases of upper limb paresthesia and lymphedema of 48.81%; Compared with the two groups, the incidence of upper limb paresthesia and lymphedema was lower in the observation group（χ^2=5.393, 4.398, P〈0.05）. At three months after surgery,the environmental, physiological, psychological, and social function scores of the observation group were（78.17±10.54）points,（65.69 ±9.11）points,（68.31 ±7.33）points,（68.77 ±7.15）points, respectively, while those in the control group were（68.45±7.68）points,（54.18±6.28）points,（59.27±5.82）points,（57.46±5.97）points, the observation group was significantly higher than the control group, with statistical differences（t=7.49, 3.59, 4.76, 6.02, P〈0.05）. Conclusion Mammectomy and axillary lymph node dissection can effectively remove cancer cells, reduce postoperative upper limb paresthesia and lymphedema, accelerate physical rehabilitation, shorten hospital stay, and improve the quality of life of patients. Therefore, it can be vigorously practiced and promoted.