保乳术联合腺体组织瓣转瓣整形术修复残腔对早期乳腺癌近远期疗效的影响

Effect of Breast-Conserving Operation Combined with Transposition Operation of Glandular Tissue Flap for Repairing Residual Cavity on Short-Term and Long-Term Curative Effects on Early Breast Cancer

目的:研究保乳术联合腺体组织瓣转瓣整形技术修复残腔对早期乳腺癌近远期疗效的影响。方法:选择笔者医院2015年5月-2018年2月诊治的96例早期乳腺癌患者,随机数表法分为对照组(47例)和研究组(49例),前者给予传统保乳术治疗,后者给予保乳术联合腺体组织瓣转瓣整形术修复残腔治疗。比较两组患者血清肿瘤标志物水平,并分析患者乳房美学评分、应对方式,统计近远期复发率。结果:两组患者术后血清肿瘤标志物均显著低于术前,差异有统计学意义(P<0.05),但术后两组之间各指标比较,差异无统计学意义(P>0.05)。乳房美学评分中,两组患者皮肤色泽、切口瘢痕评分比较无显著差异(P>0.05),其余指标评分研究组显著高于对照组(P<0.05)。两组患者手术前后应对方式各项指标评分差异显著,且术后研究组面对评分显著高于对照组,回避与压抑、屈服、幻想和发泄评分显著低于对照组(P<0.05)。两组患者术后3个月、1年和3年复发率比较无显著差异(P>0.05)。结论:保乳术联合腺体组织瓣转瓣整形术修复残腔在确保乳腺癌患者近远期治疗效果的前提下,提升患者乳房美观度、心理应对能力。

Objective This research aims to study the effect of breast-conserving operation combined with transposition operation of glandular tissue flap for repairing residual cavity on short-term and long-term curative effects on early breast cancer.Methods A total of 96 patients with early breast cancer who were diagnosed and treated in the hospital during the period from May 2015 to February 2018 were enrolled.Using random number table method,the patients were divided into control group(47 cases)and study group(49 cases).The control group was treated with traditional breast-conserving operation,and the study group was treated with breast-conserving operation combined with transposition operation of glandular tissue flap for repairing residual cavity.The levels of serum markers were compared between the two groups before and after surgery.The breast aesthetic scores and coping styles were analyzed,and the short-term and long-term recurrence rates were counted.Results The serum tumor markers of the two groups were significantly lower than those before operation (P<0.05),but there was no significant difference between the two groups (P>0.05).In the breast aesthetic score,there was no significant difference in skin color and incision scar between the two groups (P>0.05),and the scores of other indexes in the study group were significantly higher than those in the control group (P<0.05).There were significant differences in the scores of coping styles between the two groups before and after operation,and the postoperative face score of the study group was significantly higher than that of the control group,and the scores of avoidance and depression,yield,fantasy and vent were significantly lower than that of the control group (P<0.05).There was no significant difference between the two groups in the recurrence rate at 3 months,1 year and 3 years after operation (P>0.05).Conclusion Breast-conserving operation combined with transposition operation of glandular tissue flap can improve breast appearance,and psychological coping ability of breast cancer patients while ensuring the short-term and long-term curative effects.