保乳术与根治性全乳切除术治疗早期乳腺癌患者的临床效果比较及对患者生活质量的影响分析

Comparison of the Clinical Effect of Breast-conserving Surgery and Radical Mastectomy in the Treatment of Patients with Early Breast Cancer and the Analysis of the Impact on the Quality of Life of Patients

目的 探讨保乳术与根治性全乳切除术治疗早期乳腺癌患者的临床效果。方法 回顾性选取2017年1—12月厦门大学附属妇女儿童医院接诊的72例早期乳腺癌患者的临床资料,按照患者手术方案选择分组,其中采用保乳手术治疗的患者纳入观察组(n=36),根治性全乳切除术治疗的患者纳入对照组(n=36)。比较两组手术基本治疗情况、手术近期疗效、美学效果优良率、生活质量、患者中远期生存情况。结果 观察组手术时间、术中出血量、住院时间均优于对照组,差异有统计学意义(P<0.05)。观察组美学效果优良率为63.89%(23/36)低于对照组的11.11%(4/36),差异有统计学意义(χ^(2)=21.393,P<0.05)。术后观察组FACT-B量表评分显著高于对照组,差异有统计学意义(t=6.721,P<0.05)。5年的随访结果显示,两组患者5年生存率对比差异无统计学意义(χ^(2)=0.127,P>0.05)。结论 保乳术在早期乳腺癌的治疗中也基本可满足患者治疗需要,治疗近远期结局处于较好水平。并且相较根治性全乳切除术能有效控制手术切除范围,减轻手术创伤的同时减少对乳房美观度的影响,有助于患者获得更好的生活质量。

Objective To explore the clinical effects of breast-conserving surgery and radical mastectomy in the treatment of patients with early breast cancer.Methods Retrospective selection of clinical data from 72 patients with early breast cancer who were admitted to the Women and Children 's Hospital Affiliated to Xiamen University from January to December 2017.They were grouped according to the choice of surgical plan.Patients treated with breastconserving surgery were included in the observation group(n=36),and patients treated with radical mastectomy were included in the control group(n=36).The basic treatment,short-term curative effect,excellent and good rate of aesthetic effect,quality of life and long-term survival of patients were compared between the two groups.Results The operation time,intraoperative blood loss and hospitalization time of the observation group were better than those of the control group,and the differences were statistically significant(P<0.05).The excellent and good rate of aesthetic effect in the observation group was 63.89%(23/36),which was lower than 11.11%(4/36) in the control group,and the difference was statistically significant(χ^(2)=21.393,P<0.05).The postoperative FACT-B scale score of the observation group was significantly higher than that of the control group,and the difference was statistically significant(t=6.721,P<0.05).The 5-year follow-up results showed that there was no statistically significant difference in the 5-year survival rate between the two groups(χ^(2)=0.127,P>0.05).Conclusion Breast-conserving surgery can basically meet the treatment needs of patients in the treatment of early breast cancer,and the short-term and long-term outcomes of treatment are at a good level.Compared with radical mastectomy,it can effectively control the scope of surgical resection,reduce surgical trauma and reduce the impact on breast aesthetics,and help patients obtain a better quality of life.