保留乳头乳晕的乳腺切除术联合乳房重建手术的疗效观察

Efficacy of nipple-areola preserving mastectomy combined with breast reconstruction

目的探讨保留乳晕乳头的乳腺切除术联合乳房重建术应用于乳腺外科手术的临床效果。方法选取2019年2月至2020年2月间大连市中心医院收治的80例乳腺癌患者,采用随机数字表法分为观察组和对照组,每组40例。对照组患者采用乳腺切除+前哨淋巴结活检术(SLNB),观察组患者采用保乳头乳晕的乳腺切除术+SLNB+即刻假体乳房重建术治疗,比较两组患者总疗效、术后美学效果、生存质量、并发症及疾病复发情况。结果术后,观察组患者总疗效为95.0%,对照组为90.0%,两组比较,差异无统计学意义(P>0.05)。观察组患者术后美学优良率为90.0%,高于对照组的55.0%,差异有统计学意义(P<0.05)。术前,两组患者生存质量比较,差异无统计学意义(P>0.05)。术后,两组患者生活质量量表各项评分及总评分均高于术前,且观察组均高于对照组,差异均有统计学意义(均P<0.05)。两组患者术后并发症总发生率与疾病复发率比较,差异均无统计学意义(P>0.05)。结论乳腺癌患者采用保留乳头乳晕的乳腺切除术联合乳房重建术治疗方案,可获得良好的治疗有效性,术后美学效果与生活质量均更佳,且并发症与复发率皆较小,值得推广。

Objective To investigate the efficacy of nipple-areola preserving mastectomy combined with breast reconstruction in breast surgery. Methods Eighty patients with breast cancer admitted to Dalian Central Hospital were selected from February 2019 to February 2020. They were categorized into an observation group and a control group with 40 patients in each group. The observation group underwent nipple-areola preserving mastectomy plus Sentinel lymph node biopsy( SLNB) and immediate prosthetic breast reconstruction and the control group underwent mastectomy and SLNB. Overall efficacy,postoperative aesthetic effect,quality of life,complications and disease recurrence were compared between the two groups.Results The overall efficacy rate was 95. 0% in the observation group and 90. 0% in the control group( P>0.05). The aesthetic excellence rate was 90. 0% in the observation group which was significantly higher than 55. 0% of the control group( P<0.05). There was no significant difference in quality of life between the two groups before the surgery( P>0.05). After surgery,scores of quality of life were significantly increased in both groups compared with before the surgery( P>0.05). There was no significant difference in the incidence of postoperative complications between the two groups( P>0.05). Conclusion Nipple-areola preserving mastectomy combined with breast reconstruction can obtain good curative effect,aesthetic effect and quality of life for breast cancer with low complication and recurrence rate. It is worthy of promotion.