前哨淋巴结活检联合保乳术治疗早期乳腺癌的效果观察

Observation on the Effect of Sentinel Lymph Node Biopsy Combined with Breast Conserving Surgery in the Treatment of Early Breast Cancer

目的:探讨早期乳腺癌患者在经前哨淋巴结活检联合保乳术治疗后的效果。方法:选取2015年4月—2020年6月徐州医科大学附属徐州市立医院收治的102例早期乳腺癌患者作为研究对象,随机分为对照组和联合组,每组51例。对照组仅接受保乳术治疗,联合组接受前哨淋巴结活检和保乳术联合治疗,比较两组患者在手术指标、复发率、并发症发生率、乳房美容效果和创伤后应激障碍自评量表(PTSD checklist-civilian version,PCL-C)评分。结果:联合组总出血量、总引流量和住院时间均优于对照组(P<0.05);联合组术后1、3年复发率与对照组相比,差异均无统计学意义(P>0.05);联合组并发症发生率明显低于对照组(P<0.05);联合组乳房美容效果优良率高于对照组(P<0.05);术后2周,联合组PCL-C评分明显低于对照组(P<0.05)。结论:前哨淋巴结活检联合保乳术在早期乳腺癌治疗中取得良好效果,可明显降低癌症复发率和并发症发生率,乳房美容效果好,患者心理受癌症影响更小,社会认同和接受度更高。

Objective:To investigate the effect of sentinel lymph node biopsy combined with breast conserving surgery in patients with early breast cancer.Method:A total of 102 patients with early breast cancer admitted to Xuzhou Municipal Hospital Affiliated to Xuzhou Medical University from April 2015 to June 2020 were selected,they were randomly divided into control group and combined group,with 51 cases in each group.The control group was only treated with breast conserving surgery,and the combined group was treated with sentinel lymph node biopsy and breast conserving surgery.The operation status,recurrence rate,complication rate,breast cosmetic effect and PTSD checklist-civilian version(PCL-C)score were compared between the two groups.Result:The total bleeding volume,total drainage volume and hospitalization time of the combined group were better than those of the control group(P<0.05).1 year and 3 years after surgery,there were no significant differences in recurrence rates between the combined group and the control group(P>0.05).The complication rate of the combined group was significantly lower than that of the control group(P<0.05).The excellent and good rate of breast cosmetic effect in the combined group was higher than that in the control group(P<0.05).Two weeks after surgery,the PCL-C score of the combined group was significantly lower than that of the control group(P<0.05).Conclusion:Sentinel lymph node biopsy combined with breast conserving surgery has achieved good results in the treatment of stage early breast cancer,it can significantly reduce the recurrence rate of cancer and the incidence of complications,the breast cosmetic effect is good,the patient's psychology is less affected by cancer,and the social identity and acceptance are higher.