保乳术和延迟即刻重建术对乳腺癌患者影响研究
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摘要
目的:探究保乳术和延迟即刻重建术对乳腺癌患者术后恢复效果、并发症及生活质量的影响。方法:回顾性分析2016年7月至2017年12月62例乳腺癌患者的临床资料,根据术式不同将患者分为保乳组及重建组。于术后对患者乳房外观及生活质量进行评价;记录患者术后并发症发生情况;对两组患者进行随访,记录患者局部复发及远处转移情况。结果:保乳术患者乳房外观评价优良率为93.33%;重建组为87.50%,组间比较无显著性差异(P>0.05);保乳组患者功能状况评分优于重建组(P<0.05);重建组在附加关注评分上优于保乳组,差异具统计学意义(P <0.05);两组患者总并发症发生率、远期复发、局部转移及生存率比较差异均无统计学意义(P>0.05)。结论:保乳术及乳房重建术均可提高乳腺癌治疗后乳房美容度,改善患者生存质量,两者术后并发症及远期复发未见明显不同,临床上可根据患者临床资料进行术式的选择。
Objective:To investigate the effect of breast-conserving surgery and delayed immediate reconstruction on postoperative recovery,complications and quality of life of patients with breast cancer.Methods:The clinical data of 62 patients with breast cancer who were admitted to the hospital from July 2016 to December 2017 were retrospectively analyzed.They were divided into breast-conserving group and reconstruction group according to different surgical procedures.The breast appearance and quality of life were evaluated after surgery.The incidence of postoperative complications was recorded.All patients were followed up to record the local recurrence and distant metastasis.Results:The excellent and good rate of breast appearance in the breast-conserving group and the reconstruction group were 93.33% and 96.87%,respectively(P >0.05).The functional status score and additional attention score of the breast-conserving group were better than those of the reconstruction group(P <0.05).There was no significant difference in the total incidence of complications,long-term recurrence rate,local metastasis rate or survival rate between the two groups(P > 0.05).Conclusion:Breast-conserving surgery and breast reconstruction can improve the breast appearance and quality of life of patients.There is no significant difference between the two in postoperative complications or longterm recurrence.The surgery can be chosen based on the patient's clinical data.
Objective:To investigate the effect of breast-conserving surgery and delayed immediate reconstruction on postoperative recovery,complications and quality of life of patients with breast cancer.Methods:The clinical data of 62 patients with breast cancer who were admitted to the hospital from July 2016 to December 2017 were retrospectively analyzed.They were divided into breast-conserving group and reconstruction group according to different surgical procedures.The breast appearance and quality of life were evaluated after surgery.The incidence of postoperative complications was recorded.All patients were followed up to record the local recurrence and distant metastasis.Results:The excellent and good rate of breast appearance in the breast-conserving group and the reconstruction group were 93.33% and 96.87%,respectively(P >0.05).The functional status score and additional attention score of the breast-conserving group were better than those of the reconstruction group(P <0.05).There was no significant difference in the total incidence of complications,long-term recurrence rate,local metastasis rate or survival rate between the two groups(P > 0.05).Conclusion:Breast-conserving surgery and breast reconstruction can improve the breast appearance and quality of life of patients.There is no significant difference between the two in postoperative complications or longterm recurrence.The surgery can be chosen based on the patient's clinical data.
引文
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[2]Kashiwagi K,Abe Y,Ishida S,et al.Reduction mammaplasty and mastopexy for the contralateral breast after reconstruction surgery following cancer resection:A report of 3 cases.[J].Med Invest,2016,63(3~4):281~285.
[3]邵志敏,李俊杰.2015版《中国抗癌协会乳腺癌诊治指南与规范》:外科部分解读[J].中华乳腺病杂志(电子版),2016,10(1):1~5.
[4]Rivadeneira D E,Simmons R M,Fish S K,et al.Skin-sparing mastectomy with immediate breast reconstruction:a critical analysis of local recurrence.[J].Cancer Journal,2016,6(5):331.
[5]Kurokawa M,Iwai Y,Togasaki G,et al.Postoperative radiation therapy for cervical cancer:three-dimensional conformal radiation therapy(3DCRT)versus intensity modulated radiation therapy(IMRT)[J].International Journal of Radiation Oncology Biology Physics,2016,96(2S):E309.
[6]董爱萍,韩良浩.乳腺癌患者生活质量测评量表及其应用[J].肿瘤,2017,37(1):107~116.
[7]Zhou X,Li Y.Local recurrence after breast-conserving surgery and mastectomy following neoadjuvant chemotherapy for locally advanced breast cancer-a meta-analysis[J].Breast Care,2016,11(5):345.
[8]Mwakigonja A R,Rabiel H,Mbembati N A,et al.The pattern of prognostic and risk indicators among women with breast cancer undergoing modified radical mastectomy in Dar es Salaam,Tanzania[J].Infectious Agents&Cancer,2016,11(1):1~10.
[9]姜大庆,谢贤鑫,赵林,等.乳腺外科整复术在乳腺癌保乳根治术中的应用[J].现代肿瘤医学,2016,24(9):1380~1384.
[10]包刚,周恬,黄建军.Ⅱ期乳腺癌中保乳手术与改良根治术临床疗效的比较[J].中国妇幼保健,2016,31(7):1421~1423.
[11]何力.即刻乳房再造对乳腺癌根治术患者术后生存质量和生存时间的影响[J].解放军医药杂志,2017,29(10):34~37.
[12]余中国,王元正.保乳手术与改良根治术对乳腺癌患者并发症及生存预后的影响比较[J].河北医药,2018,5(2):235~238.
[13]胡俊艳,赵春英.保乳术治疗乳腺癌患者的临床效果观察[J].北京医学,2016,38(5):449~451.