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球拍形切口乳房成形术在早期乳腺癌保乳手术中的应用

徐其 郑丽 徐丹英 刘月 沈靖

徐其, 郑丽, 徐丹英, 刘月, 沈靖. 球拍形切口乳房成形术在早期乳腺癌保乳手术中的应用[J]. 中华全科医学, 2022, 20(12): 2041-2044. doi: 10.16766/j.cnki.issn.1674-4152.002765
引用本文: 徐其, 郑丽, 徐丹英, 刘月, 沈靖. 球拍形切口乳房成形术在早期乳腺癌保乳手术中的应用[J]. 中华全科医学, 2022, 20(12): 2041-2044. doi: 10.16766/j.cnki.issn.1674-4152.002765
XU Qi, ZHENG Li, XU Dan-ying, LIU Yue, SHEN Jing. Application of racquet-shaped incision mammoplasty in breast-conserving surgery for early-stage breast cancer patients[J]. Chinese Journal of General Practice, 2022, 20(12): 2041-2044. doi: 10.16766/j.cnki.issn.1674-4152.002765
Citation: XU Qi, ZHENG Li, XU Dan-ying, LIU Yue, SHEN Jing. Application of racquet-shaped incision mammoplasty in breast-conserving surgery for early-stage breast cancer patients[J]. Chinese Journal of General Practice, 2022, 20(12): 2041-2044. doi: 10.16766/j.cnki.issn.1674-4152.002765

球拍形切口乳房成形术在早期乳腺癌保乳手术中的应用

doi: 10.16766/j.cnki.issn.1674-4152.002765
基金项目: 

浙江省医药卫生科技计划项目 2018RC073

浙江省嘉兴市科技计划项目 2019AD32070

详细信息
    通讯作者:

    郑丽, E-mail: 794601639@qq.com

  • 中图分类号: R737.9 R730.56

Application of racquet-shaped incision mammoplasty in breast-conserving surgery for early-stage breast cancer patients

  • 摘要:   目的  对比分析球拍形切口乳房成形术与传统保乳术在早期乳腺癌治疗中的临床效果。  方法  选取2019年1月—2020年12月在嘉兴市第二医院本部及南湖分院就诊的早期乳腺癌患者84例,使用随机数字表法将其分为实验组和对照组,各42例。实验组采用球拍形切口乳房成形术,对照组采用传统保乳术,比较2组患者术后美容效果、手术时间、术中出血量、切除标本体积、血清肿形成率、第1次切缘阳性率、术后切口感染率及全乳切除率。  结果  实验组术后美容效果优良率为90.5%,高于对照组的61.9%,差异有统计学意义(P<0.01)。实验组切除标本体积为(89.4±23.1)mL,大于对照组的(67.7±23.9)mL,差异有统计学意义(P<0.01)。实验组2例(4.8%)患者发生血清肿,少于对照组的19例(45.2%),差异有统计学意义(P<0.01)。实验组2例(4.8%)患者第1次切缘阳性,少于对照组的8例(19.0%),差异有统计学意义(P<0.05)。2组手术时间、术中出血量、切口感染率及全乳切除率差异无统计学意义(均P>0.05)。中位随访时间为25个月,2组均未出现局部复发病例,实验组和对照组各有1例患者出现远处转移,2组远处转移率差异无统计学意义(P>0.05)。  结论  在早期乳腺癌保乳手术中使用球拍形切口乳房成形术较传统保乳术可改善术后美容效果,减少血清肿发生,降低第1次切缘阳性率,值得推广应用。

     

  • 图  1  球拍形切口乳房成形术简要手术步骤

    注:A为术前标记;B为切除“球拍柄”;C为构建“球拍面”;D为手术完成。

    Figure  1.  Brief steps of racquet-shaped incision mammoplasty

    表  1  2组早期乳腺癌患者一般资料比较

    Table  1.   Comparison of patient characteristics between two groups of early-stage breast cancer patients

    组别 例数 年龄
    (x±s,岁)
    肿瘤直径
    (x±s,cm)
    TNM分期[例(%)] 病理类型[例(%)] 腋窝淋巴结转移[例(%)]
    浸润性癌 导管内癌
    实验组 42 51.4±10.3 1.79±0.65 23(54.8) 19(45.2) 39(92.9) 3(7.1) 5(11.9) 37(88.1)
    对照组 42 50.1±10.4 1.81±0.63 24(57.1) 18(42.9) 38(90.5) 4(9.5) 4(9.5) 38(90.5)
    统计量 0.559a 0.153a 0.048b < 0.001b < 0.001b
    P 0.578 0.879 0.826 0.999 0.999
    注:at值,b为χ2值。
    下载: 导出CSV

    表  2  2组早期乳腺癌患者美容效果比较

    Table  2.   Comparison of cosmetic effects between two groups of early-stage breast cancer patients

    组别 例数
    (例)

    (例)
    一般
    (例)

    (例)
    优良率
    (%)
    实验组 42 21 17 2 2 90.5(38/42)
    对照组 42 10 16 12 4 61.9(26/42)
    注:2组优良率比较,χ2=9.450,P=0.002。
    下载: 导出CSV

    表  3  2组早期乳腺癌患者术中及术后指标比较

    Table  3.   Comparison of intraoperative and postoperative parameters between two groups of early-stage breast cancer patients

    组别 例数 手术时间
    (x±s,min)
    术中出血量
    (x±s,mL)
    切除标本体积
    (x±s,mL)
    血清肿
    [例(%)]
    切口感染
    [例(%)]
    第1次切缘
    阳性[例(%)]
    全乳切除
    [例(%)]
    实验组 42 120.6±20.6 55.3±13.7 89.4±23.1 2(4.8) 1(2.4) 2(4.8) 1(2.4)
    对照组 42 111.7±21.6 56.9±13.2 67.7±23.9 19(45.2) 2(4.8) 8(19.0) 2(4.8)
    统计量 1.950a 0.543a 4.235a 18.349b <0.001b 4.086b <0.001b
    P 0.055 0.589 <0.001 <0.001 0.999 0.043 0.999
    注:at值,b为χ2值。
    下载: 导出CSV
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出版历程
  • 收稿日期:  2022-06-04
  • 网络出版日期:  2023-02-07

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