摘要
目的 探讨前哨淋巴结活检与腋窝淋巴结清扫术在乳腺癌手术中的应用效果.方法 回顾性分析 86 例女性乳腺癌患者临床资料,将术中接受前哨淋巴结活检的43 例患者设为观察组,将术中接受腋窝淋巴结清扫术治疗的43 例患者设为对照组.比较2 组手术情况、肩关节活动度、肩关节功能、疼痛程度、免疫功能及并发症.结果 观察组术中出血量[(76.52±6.29)ml]少于对照组[(89.74±7.35)ml],手术时间[(62.35±6.25)min]、拔管时间[(4.35±0.49)d]及住院时间[(8.63±1.12)d]短于对照组[(69.74±6.48)min、(5.24±0.67)d、(10.39±1.35)d],有统计学差异(P<0.05).观察组术后外旋[(76.24±5.73)°]、内旋[(74.14±5.82)°]、屈曲[(150.32±9.82)°]、外展[(137.52±9.43)°]及肩关节Neer评分[(86.32±6.15)分]高于对照组[(68.78±5.42)°、(67.06±5.49)°、(138.97±9.37)°、(122.37±9.26)°、(80.54±6.07)分],有统计学差异(P<0.05).观察组术后d1、d3、d7 时视觉模拟评分法(VAS)评分[(5.21±1.17)分、(3.15±0.46)分、(1.42±0.29)分]低于对照组[(6.87±1.22)分、(3.87±0.52)分、(2.04±0.32)分],有统计学差异(P<0.05).观察组术后CD3+[(65.28±6.19)%]、CD4+[(43.76±4.28)%]、CD4+/CD8+[(1.90±0.29)]高于对照组[(60.14±6.05)%、(40.15±4.19)%、(1.49±0.28)],CD8+[(23.04±2.25)%]低于对照组[(26.81±2.34)%],并发症发生率低于对照组,有统计学差异(P<0.05).结论 术中进行前哨淋巴结活检可减轻对乳腺癌患者的机体创伤,降低手术对肩关节功能的影响,且对免疫功能影响更小,并发症更少.
Abstract
Objective To investigate the clinical effect of sentinel lymph node biopsy and axillary lymph node dissection in the treatment of breast cancer.Methods Clinical data of 86 female breast cancer patients were retrospectively analyzed.43 patients treated with sentinel lymph node biopsy were treated as the observation group,and 43 patients treated with axillary lymph node dissection were treated as the control group.The surgical conditions,shoulder mobility,shoulder function,pain level,immune function,and complications were compared between the 2 groups.Results The intraoperative bleeding volume in the observation group[(76.52±6.29)ml]was less than that in the control group[(89.74±7.35)ml],Operation time[(62.35±6.25)min],extubation time[(4.35±0.49)d],and hospitalization time[(8.63±1.12)d]was shorter than the control group[(69.74±6.48)min,(5.24±0.67)d,(10.39±1.35)d],Statistical difference(P<0.05);External rotation[(76.24±5.73)],internal rotation[(74.14±5.82)],flexion[(150.32±9.82)],abduction[(137.52±9.43)],and shoulder Neer score[(86.32±6.15)]were higher than the control group[(68.78±5.42),(67.06±5.49),(138.97±9.37),(122.37±9.26),(80.54±6.07)points],Statistical difference(P<0.05);The visual simulation score(VAS)score[(5.21±1.17(1.17),(3.15±0.46),0.29)]at 1 d,3 d,7 d and 7 d was lower than the control group[(6.87±1.22),(3.87±0.52),(2.04±0.32)],Statistical difference(P<0.05);The observed group had postoperative CD3+[(65.28±6.19)%],CD4+[(43.76±4.28)%],CD4+/CD8+[(1.90±0.29)]higher than the control group[(60.14±6.05)%,(40.15±4.19)%,(1.49±0.28)],The CD8+[(23.04±2.25)%]was lower than that in the control group[(26.81±2.34)%],The complica-tion rate was lower than that in the control group,Statistical difference(P<0.05).Conclusion Sentinel lymph node biopsy can reduce the impact of surgery on shoulder joint function,and have less impact on immune function and fewer complications.
维普
万方数据