中国普外基础与临床杂志

中国普外基础与临床杂志

乳腺癌保乳术中利用组织瓣修复腺体残腔的临床应用效果分析

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目的 探讨乳腺癌保乳术中利用组织瓣修复腺体残腔的临床应用效果。 方法 回顾性分析 2013 年 1 月至 2016 年 12 月期间在笔者所在医院接受乳腺癌保乳术的 120 例早期乳腺癌患者的临床资料,其中保乳术中利用组织瓣修复腺体残腔者 60 例(观察组),未行组织瓣修复腺体残腔者 60 例(对照组)。比较 2 组患者的术后并发症发生情况、术后乳房美容效果、患者满意度及复发转移情况。 结果 ① 术后并发症:对照组术后发生并发症 3 例,观察组术后发生并发症 2 例,2 组患者的并发症发生率比较差异无统计学意义(χ2=0.209,P=0.648)。② 术后乳房美容效果:对照组优 23 例,良 16 例,一般 12 例,差 9 例;观察组优 51 例,良 5 例,一般 3 例,差 1 例。观察组患者的术后乳房美容效果优于对照组(Z=–5.234,P<0.001)。③ 主观满意度:对照组十分满意 28 例,满意 18 例,一般 12 例,不满意 2 例;观察组十分满意 40 例,满意 18 例,一般 2 例。观察组患者的主观满意度优于对照组(Z=–4.381,P<0.001)。④ 随访:随访期间 2 组均无局部复发及死亡病例,但对照组发生转移 2 例,观察组发生转移 1 例,2 组患者的转移率比较差异无统计学意义(χ2=0.342,P=0.559)。 结论 乳腺癌保乳术中采用周围组织瓣修复残腔,相比于未行组织瓣修复的传统保乳手术,不增加术后手术并发症及复发转移,且术后乳房外形美容效果好,患者主观满意度高。

Objective To explore the clinical application of tissue flap in repairing the residual cavity formed by breast conserving surgery. Methods Retrospective analysis for clinical data of 120 early breast cancer patients who received breast conserving surgery in our hospital from January 2013 to December 2016 was performed. Among them, 60 cases (observation group) were implemented tissue flap repairing operation while the other 60 cases (control group) were operated by using the traditional surgery method. The clinical data of the two groups were compared analytically in four aspects: postoperative complications, postoperative breast beauty, subjective satisfaction of patients, and postoperative recurrence and metastasis. Results ① Postoperative complications: 3 cases of complications occurred in the control groupand 2 cases in the observation group, and there was no significant difference in the incidence of complications between the 2 groups (χ2=0.209, P=0.648). ② Postoperative breast beauty: in the control group, there were 23 excellent cases, 16 good cases, 12 common cases, and 9 poor cases; in the observation group, there were 51 excellent cases, 5 good cases, 3 common cases, and 1 poor cases. The difference of postoperative breast beauty between the 2 groups was statistically significant (Z=–5.234, P<0.001). ③ Subjective satisfaction of patients: in the control group, 28 cases very satisfied, 18 cases satisfied, 12 cases generally satisfied, and 2 cases dissatisfied; in the observation group, 40 cases satisfied, 18 cases very satisfied, and 2 cases generally satisfied. The subjective satisfaction of the patients in the observation group was better than that of the control group (Z=–4.381, P<0.001). ④ Postoperative follow-up: no recurrence and death occurred in both of 2 groups, but 2 cases occurred metastasis in the control group and 1 case in the observation group. The contrast difference in the incidence of metastasis was not statistically significant (χ2=0.342, P=0.559). Conclusion During breast conserving surgery, the use of surrounding tissue flap to repair residual cavity, compared with traditional breast conserving surgery without tissue flap repairment, does not increase postoperative complications, recurrence, and metastasis, and it has good cosmetic effect after breast surgery, as well as the patients’ subjective satisfaction is good.

关键词: 乳腺癌; 保乳术; 组织瓣; 效果

Key words: breast cancer; breast conserving surgery; tissue flap; effect

引用本文: 徐秀丽, 廖建伟, 赵辉, 董芳. 乳腺癌保乳术中利用组织瓣修复腺体残腔的临床应用效果分析. 中国普外基础与临床杂志, 2018, 25(2): 148-153. doi: 10.7507/1007-9424.201710078 复制

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