摘要
目的探讨乳腔镜在乳腺癌保乳手术中的应用效果。方法纳入84例早期乳腺癌患者,随机分为腔镜组及对照组各42例,分别行乳腔镜辅助下保乳手术和传统保乳手术。比较两组患者手术相关指标、手术后乳腺癌特异性量表评分及炎症反应指标。结果腔镜组手术时间长于对照组,但腔镜组术中出血量、引流液量、拔管所需时间及术后住院天数均少于对照组(均P<0.05)。两组淋巴结清扫数目及术后并发症发生率比较,差异无统计学意义(P>0.05),两组均未出现病理切缘阳性病例。术后6个月,腔镜组乳腺癌特异性量表各项评分均优于对照组(P<0.05)。腔镜组术后1 d、3 d血清C反应蛋白、白细胞介素(IL)-6、IL-8、肿瘤坏死因子-α及术后1 d前列腺素E2水平均低于对照组,而术后1 d及3 d的IL-10水平高于对照组(P<0.05),两组以上指标术后均呈先升高后降低的趋势(P<0.05)。结论乳腔镜辅助下行保乳手术能够达到乳腺癌根治目的,且较传统保乳手术创伤小、恢复快,引起全身炎症反应轻。
Objective To investigate the effect of mastoscopy applied to breast-conserving surgery for breast cancer.Methods Eighty-four patients with early breast cancer were randomly divided into endoscopic group(42 cases)and control group(42 cases).The endoscopic group and the control group received mastoscopy-assisted breast-conserving surgery and traditional breast-conserving surgery respectively.The operation-related indexes,postoperative Breast Cancer-Specific Quality of Life Questionnaire(QLQ-BR23)score,and inflammatory response index were compared between the two groups.Results The operation duration in the endoscopic group was longer than that in the control group,but the intraoperative blood loss,drainage volume,duration for extubation,and postoperative hospital stay in the endoscopic group were all less than those in the control group(all P<0.05).There was no significant difference in the number of lymph node dissection or incidence rate of postoperative complications between the two groups(P>0.05),and no pathologically positive incision margin cases were observed in the two groups.After 6 months of operation,the QLQ-BR23 scores in the endoscopic group were superior to those in the control group(P<0.05).The levels of serum C-reactive protein,interleukin(IL)-6,IL-8,IL-10 and tumor necrosis factor-alpha on the 1st and 3rd day after operation and the level of prostaglandin E 2 on the 1st day after operation were lower,but the levels of IL-10 on the 1st and 3rd day after operation were higher in the endoscopic group compared to the levels in the control group(all P<0.05),and the indexes above increased first and then decreased in both groups after operation(P<0.05).Conclusion Mastoscopy-assisted breast-conserving surgery can achieve the purpose of radical mastectomy for breast cancer,which has less trauma,faster recovery and less systemic inflammatory responses than traditional breast-conserving surgery.
作者
林胡强
陈计赏
霄超华
林显君
LIN Hu-qiang;CHEN Ji-shang;XIAO Chao-hua;LIN Xian-jun(Department of Breast Diseases,Yangjiang People′s Hospital,Yangjiang 529500,China)
出处
《广西医学》
CAS
2018年第7期799-802,811,共5页
Guangxi Medical Journal
关键词
乳腺癌
保乳手术
乳腔镜
炎症反应
Breast cancer
Breast-conserving surgery
Mastoscopy
Inflammatory response
