文章摘要
罗 迤,陈 静,张 淇,侯泽宇,程晓明.前哨淋巴结活检术联合保乳治疗对早期乳腺癌患者临床疗效、术后并发症及肩关节功能的影响[J].,2018,(22):4357-4361
前哨淋巴结活检术联合保乳治疗对早期乳腺癌患者临床疗效、术后并发症及肩关节功能的影响
Effect of Sentinel Lymph Node Biopsy Combined with Breast-conserving Therapy on the Clinical Efficacy, Postoperative Complications and Shoulder Function of Patients with Early Breast Cancer
投稿时间:2018-04-07  修订日期:2018-04-29
DOI:10.13241/j.cnki.pmb.2018.22.036
中文关键词: 前哨淋巴结活检  保乳  早期乳腺癌  疗效  并发症  肩关节功能
英文关键词: Sentinel lymph node biopsy  Breast conserving  Early breast cancer  Efficacy  Complications  Shoulder function
基金项目:贵州省遵义市汇川区科学技术局项目(209.001.107.03)
作者单位E-mail
罗 迤 遵义医学院附属医院甲乳外科 贵州 遵义 563000 luoyi574@163.com 
陈 静 遵义医学院附属医院体检中心 贵州 遵义 563000  
张 淇 遵义医学院附属医院甲乳外科 贵州 遵义 563000  
侯泽宇 遵义医学院附属医院甲乳外科 贵州 遵义 563000  
程晓明 遵义医学院附属医院甲乳外科 贵州 遵义 563000  
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中文摘要:
      摘要 目的:探讨前哨淋巴结活检术联合保乳治疗对早期乳腺癌患者临床疗效、术后并发症及肩关节功能的影响。方法:选取2014年10月至2017年2月就诊于我院的乳腺癌患者,按照患者手术方式分为联合组与对照组,其中联合组行前哨淋巴结活检手术联合保乳治疗,对照组行传统腋窝淋巴结清扫术治疗,每组各选取50例,随访时间为6个月。比较两组手术情况、并发症、乳腺美容效果及肩关节功能情况。结果:联合组手术时间、总出血量、引流管拔除时间、总引流量均明显低于对照组(P<0.05)。手术治疗后,联合组并发症比例为6%,明显低于对照组38%。术后,两组患者随访6个月,联合组乳腺美容效果明显高于对照组(P<0.05)。术前,两组肩关节功能各指标水平比较差异不显著(P>0.05);术后,两组肩关节屈曲活动度、外旋活动度、后伸活动度、外展活动度相较于术前均明显降低(P<0.05),联合组内旋活动度相较于术前降低不显著(P>0.05),而对照组内旋活动度相较于术前降低显著(P<0.05)。术后,联合组肩关节屈曲活动度、外旋活动度、内旋活动度、后伸活动度、外展活动度均显著高于对照组(P<0.05)。结论:前哨淋巴结活检术联合保乳治疗早期乳腺癌创伤小,美容效果明显,可显著降低术后并发症发生率并减轻对患者肩关节功能的损害,远期疗效仍有待于进一步随访观察。
英文摘要:
      ABSTRACT Objective: To investigate the effect of sentinel lymph node biopsy combined with breast-conserving therapy on the clinical efficacy, postoperative complications and shoulder function of patients with early breast cancer. Methods: Patients with breast cancer treated in our hospital from October 2014 to February 2017 were divided into the combined group and control group according to the patients' operation, 50 cases were selected in each group. The combined group received sentinel lymph node biopsy combined with breast-conserving therapy. The control group was treated with traditional axillary lymph node dissection. The follow-up period was 6 months. The operation condition, complications, cosmetic results and shoulder function were compared between the two groups. Results: The total operative time, total bleeding volume, drainage time and total drainage volume of the combined group were significantly lower than those of the control group (P<0.05). After surgery, the complication rate was 6% in the combined group, significantly lower than that in the control group (38%). Two groups were followed up for 6 months, the breast cosmetic effect of combined group was significantly higher than the control group (P<0.05). Before surgery, there were no significant differences in the indexes of shoulder joint function between the two groups (P>0.05). After surgery, the flexion activity, external rotation activity, extension activity and abduction activity of the two groups were significantly higher than those before operation (P<0.05). The internal rotation activity of the combined group was not significantly changed (P>0.05), while the internal rotation activity of the control group was significantly lower than that before the operation (P<0.05). After operation, the flexion activity, external rotation activity, internal rotation activity, posterior extension activity and abduction activity of the combined group were significantly higher than those of the control group (P<0.05). Conclusion: Sentinel lymph node biopsy combined with breast-conserving treatment of early breast cancer is less traumatic, obviously effective in cosmetic, and can significantly reduce the incidence of postoperative complications and the shoulder joint function damage. The long-term effect remains to be further observed.
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