保乳术联合前哨淋巴结活检与传统乳腺根治术对乳腺癌患者临床疗效及应激指标观察

Clinical efficacy and stress index analysis of breast conserving surgery combined with sentinel lymph node biopsy and traditional radical mastectomy on patients with breast cancer

目的:观察保乳术联合前哨淋巴结活检与传统乳腺根治术对乳腺癌患者的临床疗效,及对患者应激水平的影响。方法:回顾性分析本院肿瘤外科接受治疗的80例乳腺癌患者的临床资料,按照治疗方法分为对照组与观察组,每组各40例。对照组患者采取传统乳腺根治术,观察组患者采取保乳术联合前哨淋巴结活检术。比较两组患者手术时间、手术出血量、拔管时间,术后生活质量评分,并发症情况,降钙素原(PCT)、肿瘤坏死因子-α(TNF-α)水平。结果:观察组患者手术时间及拔管时间明显短于对照组患者,出血量明显小于对照组(P<0.05)。观察组患者生活质量评分明显优于对照组患者,术后总并发症发生率明显低于对照组(P<0.05)。治疗后,两组患者血清中PCT及TNF-α水平均呈现先升高后降低的趋势,同一时间点,观察组患者血清中PCT及TNF-α水平明显低于对照组(P<0.05)。结论:保乳术结合前哨淋巴结活检用于乳腺癌的治疗,可显著提高患者术后的生活质量,减少并发症的发生,引发的炎症应激反应较小,值得临床推广。

Objective:To observe the clinical effect of breast conserving surgery combined with sentinel lymph node biopsy and traditional radical mastectomy on patients with breast cancer and the influence on stress levels of patients.Methods:A retrospective analysis was made of the clinical data of 80 cases of patients with breast cancer.According to the treatment methods,they were divided into control group and observation group,each group had 40 cases.Patients in the control group were treated with traditional radical mastectomy,while patients in the observation group were treated with breast conserving surgery combined with sentinel lymph node biopsy.The operation time,bleeding volume,extubation time,postoperative quality of life score,complications,levels of PCT and TNF-α were compared between the two groups.Results:The operative time and extubation time of patients in the observation group were significantly shorter than those in the control group,and the amount of bleeding was significantly lower than that of the control group(P<0.05).The postoperative quality of life of patients in the observation group was significantly better than that in the control group,and the incidence of postoperative complications was significantly lower than that of the control group(P<0.05).After treatment,the serum levels of PCT and TNF-α in the two groups showed a trend of first increase and then decrease.At the same time point after operation,the levels of serum PCT and TNF-α of patients in the observation group were significantly lower than those in the control group(P<0.05).Conclusion:Breast conserving surgery combined with sentinel lymph node biopsy can significantly improve the postoperative quality of life and reduce the incidence of complications in the treatment of patients with breast cancer.The inflammatory stress reaction induced by this method is smaller than traditional radical mastectomy,and it is worthy of clinical promotion.