超声下真空辅助微创旋切对乳腺良性肿瘤患者应激指标和肿瘤标志物的影响

Effects of ultrasound-assisted minimally invasive rotary resection on stress indexes and tumor markers in patients with benign breast tumors

目的 探讨超声下真空辅助微创旋切对乳腺良性肿瘤患者应激指标和肿瘤标志物的影响。方法 选取2021年5月—2023年5月在天津市泰达医院治疗乳腺良性肿瘤的136例患者。通过抽签法随机分为两组,对照组传统开放手术方式治疗,观察组运用超声下真空辅助微创旋切手术治疗。对两组患者的手术情况、应激指标水平、肿瘤标志物指标、乳房的美观效果及术后并发症进行对比分析。结果 (1)观察组的手术时间(18.95±5.25)min、术中出血量(8.62±2.25)ml、术后当日VAS评分(2.15±0.32)d、瘢痕长度(1.95±0.12)mm及住院时间(4.26±0.37)d均低于对照组,差异有统计学意义(P<0.05);(2)术后3~7 d,两组患者的NE、E及Cor水平均下降,且术后7 d的指标水平较3 d低,观察组的NE(10.98±2.29)mmol/L、(6.63±1.08)mmol/L、E(118.73±14.64)mmol/L、(101.34±19.13)mmol/L、Cor(15.88±1.43)mmol/L、(9.37±2.31)mmol/L水平均低于对照组(P<0.05);(3)术前,两组患者两组血清CEA和CA125水平差异无统计学意义(P>0.05),术后3 d和术后7 d,两组患者的血清CEA和CA125水平均降低,且术后7 d的指标水平较3 d低,观察组的血清CEA(3.59±0.43)ng/ml、(2.84±0.39)ng/ml、CA125(13.85±2.41)U/ml及(11.35±1.96)U/ml较对照组低(P<0.05);(4)观察组患者术后乳房的美观优良率95.59%(65/68)较对照组高(P<0.05);(5)术后6个月观察组并发症发生率4.41%(3/68)较低(P<0.05)。结论 超声下真空辅助微创旋切治疗良性的乳腺肿瘤,在一定程度上能缩短手术时间,减少术中出血量,有效缩短患者术后恢复时间,减轻术后当天疼痛情况,且术后瘢痕较小,此外乳腺良性肿瘤带给患者的应激反应较轻,且对患者的血清肿瘤标志物的改善无特殊不良影响。该手术方法在提高乳房外观美感度的同时还能降低患者术后并发症的发生概率。

Objective To investigate the effects of ultrasound-guided vacuum assisted minimally invasive rotary resection on stress in⁃dicators and tumor markers in patients with benign breast tumors.Methods 136 patients who were treated with benign breast tumors at Tian⁃jin Teda Hospital from May 2021 to May 2023 were selected.Randomly divided into two groups by drawing lots,the control group was treated with traditional open surgery,while the observation group was treated with ultrasound-guided vacuum assisted minimally invasive rotary re⁃section surgery.Compare and analyze the surgical conditions,stress index levels,tumor marker indicators,breast aesthetic effects,and postoperative complications between two groups of patients.Results①The surgical time(18.95±5.25)min,intraoperative blood loss(8.62±2.25)ml,postoperative day VAS score(2.15±0.32)d,scar length(1.95±0.12)mm,and hospital stay(4.26±0.37)d in the observation group were all lower than those in the control group,and the differences were statistically significant(P<0.05);②From 3 to 7 days after surgery,the levels of NE,E,and Cor in both groups of patients decreased,and the levels of indicators were lower than those in 3 days after surgery.The levels of NE(10.98±2.29)mmol/L,(6.63±1.08)mmol/L,E(118.73±14.64)mmol/L,(101.34±19.13)mmol/L,Cor(15.88±1.43)mmol/L and(9.37±2.31)mmol/L in the observation group were lower than those in the control group,with(P<0.05);③Before surgery,there was no significant difference in serum CEA and CA125 levels between the two groups of patients(P>0.05).On the 3 and 7 th day after surgery,the serum CEA and CA125 levels in both groups decreased,and the indicators on the 7 th day after surgery were lower than those on the 3rd day.The observation group had serum CEA(3.59±0.43)ng/ml,(2.84±0.39)ng/ml,and CA125(13.85±2.41)U/ml,(11.35±1.96)U/ml,which were lower than those on the control group(P<0.05);④The observation group had a 95.59%(65/68)improvement rate in breast aesthetics after surgery Higher than the control group(P<0.05);⑤The incidence rate of complications in the observation group at 6 months after surgery was 4.41%(3/68),which was relatively low(P<0.05).Conclusion Ultrasound assisted vacuum assisted minimally invasive rotary resection for benign breast tumors can not only shorten the surgical treatment time to a certain extent,but also reduce intraoperative bleeding,effectively shorten the recovery time of patients, and also alleviate pain on the day after surgery. In addition, benign breast tumors bring less stress response to patients, And there isno adverse special effect on the improvement of serum tumor markers in patients. In addition, this treatment can improve the aesthetic ap⁃pearance of the breast while also reducing the probability of postoperative complications in patients to some extent.