改良根治术和保乳手术治疗乳腺癌的疗效对比研究

Comparative Study on the Efficacy of Modified Radical Mastectomy and Breast-conserving Surgery for Breast Cancer

目的探讨对乳腺癌患者予以改良根治术和保乳手术治疗的效果差异。方法选择2017年1月—2019年12月丹阳市人民医院收治的80例乳腺癌患者,通过随机数表法分为对照组(n=40,接受改良根治术治疗)与观察组(n=40,接受保乳手术治疗)。比较两组手术相关指标,评价患者远期疗效,并于术后1年采用乳腺癌患者生命质量测定量表(FACT-B)评估患者生活质量。结果观察组手术时间(139.47±19.85)min、出血量(43.60±3.91)mL、引流量(385.14±37.60)mL、切口长度(6.08±0.52)cm、住院时间(12.76±1.85)d优于对照组,差异有统计学意义(t=6.048、23.541、4.720、37.770、10.633,P<0.05)。观察组局部复发率、远端转移率、病死率分别为7.50%、5.00%、2.50%,与对照组(5.00%、2.50%、5.00%)比较,差异无统计学意义(χ^(2)=0.000、0.000、0.000,P>0.05)。观察组FACT-B评分在生理、功能、情感、社会、附加关注5个维度分别为(19.78±2.05)分、(20.30±2.45)分、(15.75±1.96)分、(18.72±2.15)分、(25.08±4.17)分,均高于对照组,差异有统计学意义(t=11.642、8.570、12.335、8.756、4.129,P<0.05)。结论对乳腺癌手术患者予以保乳手术治疗较改良根治术对患者损伤更小,有利于改善患者术后生存质量,且两种术式远期疗效相当。

Objective To explore the difference between modified radical mastectomy and breast-conserving surgery for breast cancer.Methods 80 patients with breast cancer admitted to Danyang People’s Hospital from January 2017to December 2019 were divided into the control group(n=40,receiving modified radical mastectomy)and the observation group(n=40,receiving breast conserving surgery)according to the random table method.The operation related indexes of the two groups were compared to evaluate the long-term efficacy of the patients,and the quality of life of patients with breast cancer was evaluated with the Quality of Life Inventory for Breast Cancer Patients(FACT-B)one year after operation.Results The operation time(139.47±19.85)min,bleeding volume(43.60±3.91)mL,drainage volume(385.14±37.60)mL,incision length(6.08±0.52)cm,and hospital stay(12.76±1.85)d in the observation group were better than those in the control group,and the difference was statistically significant(t=6.048,23.541,4.720,37.770,10.633,P<0.05).The local recurrence rate,distal metastasis rate and fatality rate in the observation group were 7.50%,5.00%and 2.50%,respectively,and there was no statistically significant difference compared with the control group(5.00%,2.50%and 5.00%)(χ^(2)=0.000,0.000,0.000,P>0.05).The FACT-B score of the observation group was higher than that of the control group in the five dimensions of physiology,function,emotion,society and additional attention,respectively(19.78±2.05)points,(20.30±2.45)points,(15.75±1.96)points,(18.72±2.15)points and(25.08±4.17)points,and the difference was statistically significant(t=11.642,8.570,12.335,8.756,4.129,P<0.05).Conclusion Breast-conserving surgery for patients with breast cancer is more effective than modified radical mastectomy in improving the quality of life of patients,and the long-term efficacy of the two methods is similar.