摘要
目的分析环乳晕入路保留乳头乳晕乳腺癌改良根治术(环乳晕入路NSM)治疗早期乳腺癌患者的效果。方法选取河南省荥阳市人民医院2016年5月至2019年1月收治的86例早期乳腺癌患者为研究对象,依照随机数字表法分为两组。观察组(43例)接受环乳晕入路NSM治疗,对照组(43例)接受乳腺癌标准切除术治疗。比较两组手术时间、淋巴结清扫数量、术中失血量、美容学优良率、术后1年局部复发率、远处转移率、生存率、生活质量,及术前及术后3 d应激指标水平[血清一氧化氮(NO)、超氧化物歧化酶(SOD)、皮质醇(Cor)]。结果与对照组对比,观察组手术时间较长,术中失血量较少,差异有统计学意义(P<0.05);而淋巴结清扫数量比较,差异无统计学意义(P>0.05)。与对照组美容学优良率(69.05%)比较,观察组(92.86%)较高,差异有统计学意义(P<0.05)。术后1年,观察组局部复发率(4.76%)、远处转移率(7.14%)、生存率(92.86%)与对照组(7.14%、7.14%、90.48%)比较,差异无统计学意义(P>0.05)。术后1年,观察组乳腺癌患者生命质量测定量表(QLQ-BR53)评分较对照组低,差异有统计学意义(P<0.05)。术后3 d,观察组血清NO、SOD水平较对照组高,血清Cor水平较对照组低,差异有统计学意义(P<0.05)。结论环乳晕入路NSM治疗早期乳腺癌,手术时间较长,效果确切,能有效减少术中失血量,提高美容学效果、生活质量,减小对应激指标影响,且不会降低预后效果。
Objective To analyze the effect of modified radical mastectomy with nipple-sparing areola approach(NSM)in the treatment of patients with early breast cancer.Methods The 86 patients with early breast cancer admitted to Xingyang People’s Hospital of Henan Province from May 2016 to January 2019 were selected as the research objects and divided into two groups according to the random number table method.The observation group(N=43)received NSM via circumareola approach,while the control group(N=43)received standard resection of breast cancer.The operation time,the number of lymph nodes dissected,intraoperative blood loss,excellent and good cosmetic rate,the local recurrence rate at 1 year after operation,distant metastasis rate,survival rate,quality of life,and stress index levels[serum nitric oxide(NO),superoxide dismutase(SOD),cortisol(Cor)]before and 3 days after operation were compared between the two groups.Results Compared with the control group,the operation time of the observation group was longer,the intraoperative blood loss was less,and the difference was statistically significant(P<0.05).There was no significant difference in the number of lymph nodes dissected(P>0.05).The observation group(92.86%)had a higher rate of cosmetic excellence compared to the control group(69.05%),and the difference was statistically significant(P<0.05).There was no significant difference in local recurrence rate(4.76%),distant metastasis rate(7.14%),and survival rate(92.86%)between the observation group and the control group(7.14%,7.14%,90.48%)at 1year after the operation(P>0.05).One year after operation,the QLQ-BR53 score of breast cancer patients in the observation group was lower than that in the control group,and the difference was statistically significant(P<0.05).On postoperative 3days,the levels of serum NO and SOD in the observation group were higher than those in the control group,and the levels of serum Cor were lower than those in the control group,and the differences were statistically significant(P<0.05).Conclusions The periareolar approach of NSM in the treatment of early breast cancer has a longer operation time and exact effect,which can effectively reduce intraoperative blood loss,improve the cosmetic effect,and quality of life,reduce the impact on stress indicators,and will not reduce the prognosis effect.
作者
王景
惠丽
WANG Jing;HUI Li(Department of General Surgery,Xingyang People's Hospital,Zhengzhou Henan 450100,China)
出处
《临床研究》
2022年第11期23-26,共4页
Clinical Research
关键词
环乳晕入路
保留乳头乳晕
改良根治术
早期
乳腺癌
annular areola approach
preserve the nipple and areola
modified radical resection
early
breast cancer
