保留乳头乳晕的乳腺癌改良根治术同期假体植入乳房重建术治疗早期乳腺癌的效果
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摘要
目的探讨保留乳头乳晕的乳腺癌改良根治术同期假体植入乳房重建术治疗早期乳腺癌的临床效果。方法选取2015年2月～2017年2月我院收治的92例早期乳腺癌患者,随机分为研究组和参照组,每组各46例。参照组采用传统改良根治术治疗,研究组则采用保留乳头乳晕的乳腺癌改良根治术同期假体植入乳房重建术治疗,比较两组的临床效果。结果研究组的术后乳房外观优良率为93.48%,显著高于参照组的71.74%,差异有统计学意义(P<0.05)。两组的并发症发生率比较,差异无统计学意义(P>0.05)。两组患者的肿瘤局部复发率、淋巴结转移率比较,差异无统计学意义(P>0.05)。结论采用保留乳头乳晕的改良根治术联合假体置入术乳房重建术治疗能使早期乳腺癌患者获得较好的乳房外观,且不会增加肿瘤复发或转移以及相关并发症的危险性,效果良好,值得临床进一步应用。
Objective To investigate the clinical effect of modified radical mastectomy for breast cancer with nipple and areola preservation and reconstruction of breast with prosthesis implantation in the treatment of early breast cancer.Methods From February 2015 to February 2017, 92 patients with early breast cancer in our hospital were selected and randomly divided into the study group and the reference group, with 46 cases in each group. The reference group was treated with traditional modified radical mastectomy, while the study group was treated with modified radical mastectomy with nipple and areola preservation and breast reconstruction with prosthesis implantation. The clinical effects were compared between the two groups. Results The excellent and good rate of breast appearance in the study group was93.48%, which was significantly higher than that in the control group(71.74%), the difference was statistically significant(P<0.05). There was no significant difference in the incidence of complications between the two groups(P>0.05).There was no significant difference in tumor recurrence rate and lymph node metastasis rate between the two groups(P >0.05). Conclusion The modified radical mastectomy combined with prosthesis reconstruction can obtain better breast appearance without increasing the risk of tumor recurrence or metastasis and related complications. It is worthy of further clinical application.
Objective To investigate the clinical effect of modified radical mastectomy for breast cancer with nipple and areola preservation and reconstruction of breast with prosthesis implantation in the treatment of early breast cancer.Methods From February 2015 to February 2017, 92 patients with early breast cancer in our hospital were selected and randomly divided into the study group and the reference group, with 46 cases in each group. The reference group was treated with traditional modified radical mastectomy, while the study group was treated with modified radical mastectomy with nipple and areola preservation and breast reconstruction with prosthesis implantation. The clinical effects were compared between the two groups. Results The excellent and good rate of breast appearance in the study group was93.48%, which was significantly higher than that in the control group(71.74%), the difference was statistically significant(P<0.05). There was no significant difference in the incidence of complications between the two groups(P>0.05).There was no significant difference in tumor recurrence rate and lymph node metastasis rate between the two groups(P >0.05). Conclusion The modified radical mastectomy combined with prosthesis reconstruction can obtain better breast appearance without increasing the risk of tumor recurrence or metastasis and related complications. It is worthy of further clinical application.
引文
[1]邵志平,胡孝渠,李继承,等.保留乳头乳晕的乳腺癌改良根治术与传统根治术对比[J].中国妇幼保健,2015,30(12):1946-1948.
[2]艾尼·沙塔尔,李炳军,张卫群.绝经期早期乳腺癌患者根治术中留取乳头乳晕联合假体植入的效果及生存质量、并发症观发生率探讨分析[J].中外医疗,2017,36(9):42-44.
[3]梁婧,高学平,林农,等.放射状切口与横切口在保留NAC的乳腺癌改良根治术加Ⅰ期假体植入重建术中的手术效果对比分析[J].中国卫生标准管理,2016,7(23):79-81.
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[5]刘慧民,白海亚,杨萍,等.腔镜辅助保留乳头乳晕乳腺癌手术Ⅰ期假体乳房重建的探讨[J].甘肃医药,2014,15(11):825-828.
[6]崔智淼,骆成玉,李鑫,等.乳腔镜辅助保留NAC乳腺癌改良根治术并假体植入Ⅰ期成形的临床研究[J].首都医科大学学报,2016,37(3):341-345.
[7]邹伟伟,白玉,王希龙,等.胸大肌筋膜在乳腺癌乳房切除后即刻乳房重建中的应用[J].中国普通外科杂志,2017,26(11):1447-1452.
[8]黄佳鹏,庄亚强,覃舒婷,等.保留皮肤的青年乳腺癌改良根治术后即刻乳房再造与改良根治术的比较分析[J].中国肿瘤临床,2016,43(3):100-104.
[9]李嘉.保留乳头乳晕复合体一期乳房再造与乳房改良根治术的临床研究[J].中国医学创新,2013,22(9):24-25.
[10]仉玮,吴彦岚,田焕,等.乳腺癌术后Ⅰ期假体植入乳房重建术42例临床分析[J].广东医学,2016,37(4):546-548.
[11]杨华伟,刘剑仑,韦薇,等.乳腺癌术后Ⅰ期乳房重建78例报告[J].广西医科大学学报,2013,30(2):280-282.
[12]陈淑如,吴楚成,颜宁,等.保留乳头乳晕改良根治术联合假体置入术治疗早期乳腺癌效果观察[J].山东医药,2015,55(2):91-93.
[13]袁春雷,王琳.乳腺癌改良根治术后即刻乳房重建对患者生活质量的影响研究[J].中国当代医药,2014,21(34):28-30.
[14]刘国华.乳腺癌改良根治术后即刻背阔肌皮瓣乳房重建对女性乳腺癌患者术后自我效能感及生活质量的影响[J].河南医学研究,2017,26(14):2508-2510.
[15]王萌萌,王京,华建芬,等.保留乳头乳晕的乳腺癌改良根治术联合Ⅰ期假体植入与传统乳腺癌改良根治术的临床疗效对比[J].中国妇幼保健,2017,32(23):6040-6043.
[2]艾尼·沙塔尔,李炳军,张卫群.绝经期早期乳腺癌患者根治术中留取乳头乳晕联合假体植入的效果及生存质量、并发症观发生率探讨分析[J].中外医疗,2017,36(9):42-44.
[3]梁婧,高学平,林农,等.放射状切口与横切口在保留NAC的乳腺癌改良根治术加Ⅰ期假体植入重建术中的手术效果对比分析[J].中国卫生标准管理,2016,7(23):79-81.
[4]范庆海.保留乳头乳晕乳腺癌改良根治术的临床应用效果[J].航空航天医学杂志,2015,26(8):956-957.
[5]刘慧民,白海亚,杨萍,等.腔镜辅助保留乳头乳晕乳腺癌手术Ⅰ期假体乳房重建的探讨[J].甘肃医药,2014,15(11):825-828.
[6]崔智淼,骆成玉,李鑫,等.乳腔镜辅助保留NAC乳腺癌改良根治术并假体植入Ⅰ期成形的临床研究[J].首都医科大学学报,2016,37(3):341-345.
[7]邹伟伟,白玉,王希龙,等.胸大肌筋膜在乳腺癌乳房切除后即刻乳房重建中的应用[J].中国普通外科杂志,2017,26(11):1447-1452.
[8]黄佳鹏,庄亚强,覃舒婷,等.保留皮肤的青年乳腺癌改良根治术后即刻乳房再造与改良根治术的比较分析[J].中国肿瘤临床,2016,43(3):100-104.
[9]李嘉.保留乳头乳晕复合体一期乳房再造与乳房改良根治术的临床研究[J].中国医学创新,2013,22(9):24-25.
[10]仉玮,吴彦岚,田焕,等.乳腺癌术后Ⅰ期假体植入乳房重建术42例临床分析[J].广东医学,2016,37(4):546-548.
[11]杨华伟,刘剑仑,韦薇,等.乳腺癌术后Ⅰ期乳房重建78例报告[J].广西医科大学学报,2013,30(2):280-282.
[12]陈淑如,吴楚成,颜宁,等.保留乳头乳晕改良根治术联合假体置入术治疗早期乳腺癌效果观察[J].山东医药,2015,55(2):91-93.
[13]袁春雷,王琳.乳腺癌改良根治术后即刻乳房重建对患者生活质量的影响研究[J].中国当代医药,2014,21(34):28-30.
[14]刘国华.乳腺癌改良根治术后即刻背阔肌皮瓣乳房重建对女性乳腺癌患者术后自我效能感及生活质量的影响[J].河南医学研究,2017,26(14):2508-2510.
[15]王萌萌,王京,华建芬,等.保留乳头乳晕的乳腺癌改良根治术联合Ⅰ期假体植入与传统乳腺癌改良根治术的临床疗效对比[J].中国妇幼保健,2017,32(23):6040-6043.