不同手术方法治疗早期乳腺癌的疗效及美容效果比较

马春雷+梁金龙+刘晓娟+程立文+曲书岚

[摘要] 目的 對比研究保乳手术与改良根治术治疗早期乳腺癌的手术效果及美容效果。方法 选择2013年1月～2016年1月在我院行手术治疗的早期乳腺癌患者50例，将其中行保乳手术的患者25例设立为保乳组，其余25例行改良根治术的患者设立为改良组，比较两组的切口大小、术中出血量、术后住院时间及并发症情况，并对两组患者的美容效果进行评价。 结果 保乳组患者的切口长度（4.0±1.8）cm，明显短于改良组，保乳组患者的术中出血量（31.0±6.3）mL，明显少于改良组，保乳组患者的术后住院天数（10.5±2.3）d，明显短于改良组，保乳组术后发生皮下积液、皮瓣缺血各2例，其并发症发生率16.0%，明显少于改良组，差异有统计学意义（P<0.05）。 保乳组患者的美容效果优良率达68.0%，显著高于改良组44.0%，差异有统计学意义（P<0.05）。结论 保乳手术较改良根治术治疗早期乳腺癌的手术效果好，术中出血少、术后并发症少，且美容效果好，有利于改善患者的生活质量及促进疾病恢复。

[关键词] 早期乳腺癌；保乳手术；改良根治术；美容效果

[中图分类号] R730.56 [文献标识码] B [文章编号] 1673-9701（2017）07-0046-03

[Abstract] Objective To comparatively study the curative effect and cosmetic effect of breast conserving surgery and modified radical mastectomy on early breast cancer.Methods 50 patients with early breast cancer who underwent surgical treatment in our hospital from January 2013 to January 2016 were enrolled.Among them，25 patients treated with breast conserving surgery were referred as breast-conserving group. The remaining 25 patients who underwent modified radical mastectomy were chosen as the control group. The incision size， intraoperative blood loss， postoperative hospital stay and complications were compared between the two groups， and the cosmetic effect between the two groups was evaluated. Results The incision length of the breast-conserving group was（4.0±1.8）cm， which was significantly shorter than that of the control group. The intraoperative blood loss was （31.0±6.3）mL in the breast-conserving group， which was significantly lower than that in the control group. The number of hospitalization days was （10.5±2.3） days， shorter than that of the control group.In the breast conserving group， there were 2 cases of subcutaneous effusion and 2 cases of flap ischemia，and the complication rate was 16.0%，significantly lower than that of the control group.And there was significant difference between the two groups（P<0.05）.The excellent and good rate of cosmetic treatment was 68.0% in the breast conserving group， which was significantly higher than that of the control group （44.0%）. The difference was statistically significant （P<0.05）.Conclusion The surgical effect of breast conserving surgery is better compared with that of modified radical mastectomy in the treatment of early breast cancer，with less intraoperative blood loss， less postoperative complications and good cosmetic effect， which is beneficial to improve the quality of life of patients and promote disease recovery.

[Key words] Early breast cancer； Breast conserving surgery；Modified radical mastectomy； Cosmetic effect

乳腺癌为女性常见的恶性肿瘤之一，发病率及病死率较高。目前临床对早期乳腺癌主要采取手术治疗。保乳手术与改良根治术为常用的手术方法之一，但改良根治术创伤大、术后并发症多、患者恢复慢，严重影响患者的形体美观[1]。保乳手术在确保手术效果的同时，保留了乳房外形，越来越得到患者的认可。保乳手术目前已经成为治疗乳腺癌的首选方法之一，研究证实，随着患者对形体美观效果要求的不断提高，该手术方法在保障疗效与安全性的基础上可以满足患者的保留乳房完整性的美观的要求[2-3]。本文旨在对比分析保乳手术与改良根治术治疗早期乳腺癌的临床效果，现报道如下。……