摘要
目的 分析对于早期乳腺癌患者分别采取改良根治术和保乳术的临床价值.方法 回顾性分析2020年4月至2022年4月在漳州正兴医院就诊的早期乳腺癌患者的临床资料,根据所采取手术方案的不同分为改良根治术组(对照组)和保乳术组(观察组),每组50例.比较分析两组研究对象的手术指标、术后乳房美学情况、远期预后情况、近期并发症发生情况和睡眠质量.结果 观察组患者的术后出血量显著少于对照组(P<0.001);且观察组研究对象手术所需时长和住院总时长均显著短于对照组(P<0.001).术后一年,观察组患者乳房美学平整度、对称性、皮肤效果、皮肤色泽、切口瘢痕、乳头移动评分均显著高于对照组(P<0.001).两组患者的生存率(P=0.695)、局部复发率(P=0.400)、远处转移率(P=0.558)均无显著差异.观察组患者中有2例出现近期并发症,显著低于对照组患者中8例出现近期并发症(P=0.046).治疗后观察组患者入睡时间,睡眠时间、质量、效率、障碍,催眠药物,日间功能障碍以及PSQI总分均显著低于对照组(P<0.001).结论 对于早期乳腺癌患者,保乳手术和改良根治术均可清除病灶组织,但保乳术更加有利于患者术后恢复,保障了患侧乳腺的美观程度,安全性较高,且有利于患者术后睡眠质量的恢复.
Abstract
Objective To analyze the clinical value of performing modified radical mastectomy versus breast-conserving surgery in patients with early-stage breast cancer. Methods A retrospective analysis was conducted on the clinical data of early-stage breast cancer patients treated at Zhangzhou Zhengxing Hospital from April 2020 to April 2022. Based on the surgical approach,patients were divided into a modified radical mastecto-my group (control group) and a breast-conserving surgery group (observation group),with 50 cases in each group. Surgical indicators,postoperative breast aesthetics,long-term prognosis,short-term complications,and sleep qual-ity were compared between the two groups. Results The postoperative blood loss in the observation group was significantly less than that in the control group (P<0.001). The surgery duration and total hospital stay in the ob-servation group were significantly shorter than those in the control group (P<0.001). One year postoperatively,the observation group had significantly higher scores in breast aesthetics,including smoothness,symmetry,skin appear-ance,skin color,incision scars,and nipple movement (P<0.001). There were no significant differences in survival rate (P=0.695),local recurrence rate (P=0.400),and distant metastasis rate (P=0.558) between the two groups. The observation group had 2 cases of short-term complications,significantly fewer than the 8 cases in the control group (P=0.046). Post-treatment,the observation group had significantly better sleep quality indicators,including sleep onset time,sleep duration,sleep quality,sleep efficiency,sleep disturbances,use of hypnotics,daytime dysfunction,and total PSQI score,compared to the control group (P<0.001). Conclusion For patients with early-stage breast cancer,both breast-conserving surgery and modified radical mastectomy effectively remove the tumor tissue. How-ever,breast-conserving surgery is more beneficial for postoperative recovery,maintaining the aesthetic appearance of the affected breast,ensuring higher safety,and improving postoperative sleep quality.
维普
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