探讨保乳手术与改良根治术对早期乳腺癌的效果及并发症发生率

To investigate of the Effect of Breast-conserving Surgery and Modified Radical Mastectomy on Early Breast Cancer and the Incidence of Compli⁃cation

目的 探讨保乳手术与改良根治术对早期乳腺癌的效果。方法 随机选取2018年1月—2021年1月福建省南平市第二医院收治的120例早期乳腺癌患者为研究对象,随机分为对照组和研究组,各60例。对照组实施改良根治术,研究组实施小切口保乳手术。观察并比较两组患者手术相关指标、乳房外观优良性、并发症、手术前后肿瘤标志物检测情况、术后1年局部复发、远处转移及创伤后应激障碍指标。结果 研究组手术用时、切口长度、失血量、引流量手术相关指标均明显优于对照组,差异有统计学意义(t=12.571、15.462、21.400、103.319,P<0.05)。研究组乳房外观优良性(96.67%)明显高于对照组(73.33%),差异有统计学意义(χ^(2)=11.810,P<0.05)。研究组术后并发症发生率(3.33%)明显低于对照组(16.67%),差异有统计学意义(χ^(2)=4.537,P<0.05)。术前两组患者的血清癌胚抗原、糖类抗原153指标差异无统计学意义(P>0.05);术后3 d研究组患者的血清癌胚抗原、糖类抗原153指标明显低于对照组,差异有统计学意义(t=3.197、2.288,P<0.05)。两组患者术后1年局部复发率(1.67%)与远处转移率(3.33%)差异无统计学意义(χ^(2)=0.000、0.000,P>0.05)。研究组术后1年PCL评分明显低于对照组,差异有统计学意义(t=19.585,P<0.05)。结论 小切口保乳手术更利于改善早期乳腺癌患者手术创伤性,减少术后并发症,降低肿瘤标志物检测水平,减轻患者创伤后应激反应,提高乳房外观优良性。

Objective To discuss the effect of breast-conserving surgery and modified radical surgery on early breast cancer.Methods 120 patients with early breast cancer admitted to the Second Hospital of Nanping from January 2018 to January 2021 were randomly selected,and they were randomly divided into the control group and the study group,with 60 cases in each group,and modified radical surgery was performed in the control group,breast-conserving sur⁃gery with small incisions was performed in the study group.Surgery-related indicators,excellent breast appearance,complications,detection of tumor markers before and after surgery,1-year postoperative local recurrence,distant me⁃tastasis and PTSD indicators were observed and compared between the two groups.Results The surgical time,incision length,blood loss,and drainage surgical-related indexes in the study group were significantly better than those in the control group,the difference was statistically significant(t=12.571,15.462,21.400,103.319,P<0.05).The excellent quality of breast appearance in the study group(96.67%)was significantly higher than that in the control group(73.33%),and the difference was statistically significant(χ^(2)=11.810,P<0.05).The incidence of postoperative compli⁃cations in the study group(3.33%)was significantly lower than that in the control group(16.67%),and the difference was statistically significant(χ^(2)=4.537,P<0.05).There was no statistically significant difference in serum carcinoem⁃bryonic antigen and sugar antigen 153 index between the two groups before surgery(P>0.05);the serum cancerembryonic antigen and sugar antigen 153 index in the study group were significantly lower than those of the control group,and the difference was statistically significant(t=3.197,2.288,P<0.05).There was no statistically significant difference in the local recurrence rate(1.67%)and the distant metastasis rate(3.33%)between the two groups(χ^(2)=0.000,0.000,P>0.05).The PCL score in the study group was significantly lower than that of the control group,and the difference was statistically significant(t=19.585,P<0.05).Conclusion Small incision breast-conserving surgery is more favorable to improve surgical invasiveness,reduce postoperative complications,lower the level of tumor marker detection,reduce post-traumatic stress response of patients,and improve the excellent appearance of the breast in early breast cancer patients.