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球拍形切口乳房成形术对早期乳腺癌保乳手术患者美观效果与社会心理适应影响 被引量:1

Effect of racket-shaped incision mammaplasty on aesthetic effect and psychosocial adaptation of early breast cancer patients undergoing breast conserving surgery
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摘要 目的:分析球拍形切口乳房成形术(RSIM)治疗早期乳腺癌(MC)保乳手术患者的效果。方法:选取某院85例早期MC保乳手术患者为研究对象,依照患者选择手术方式意愿分为2组,接受RSIM治疗为观察组(n=43例),接受常规保乳手术治疗为对照组(n=42例),比较2组手术情况(手术时间、术中失血量)、乳房美观效果(瘢痕、凹陷程度、乳房顺应性差值、对称性、乳头横向偏移距离、皮肤颜色、乳头纵向偏移距离、质地与弹性)、并发症发生率及社会心理适应水平(心理社会适应能力测评问卷)。结果:2组手术时间、术中失血量比较差异无统计学意义(P>0.05)。术后2个月,观察组瘢痕评分[(2.64±0.38)分]、凹陷程度评分[(2.59±0.37)分]、对称性评分[(2.71±0.42)分]、乳头横向偏移距离评分[(3.03±0.41)分]及乳头纵向偏移距离评分[(2.98±0.36)分]低于对照组[(3.17±0.42)分、(3.14±0.35)分、(3.20±0.43)分、(3.56±0.42)分、(3.25±0.40)分](P<0.05),而2组乳房顺应性差值、皮肤颜色及质地与弹性评分比较差异无统计学意义(P>0.05)。观察组近期(9.30%)和远期(16.28%)并发症发生率低于对照组(33.33%和45.24%)(P<0.05)。术后2个月,观察组焦虑/抑郁评分[(28.12±3.05)分]、态度评分[(33.79±4.08)分]、自尊/自我接纳评分[(33.54±2.67)分]及自我效能评分[(33.26±1.94)分]高于对照组[(18.14±2.63)分、(25.12±3.66)分、(24.07±3.11)分、(26.05±2.13)分](P<0.05)。结论:早期MC保乳手术患者接受RSIM治疗,不仅能减少并发症、提高乳房美观效果,还可在一定程度上提高患者社会心理适应水平。 Objective:To analyze the effect of racket-shaped incision mammaplasty(RSIM) in the treatment of early breast cancer(MC) patients undergoing breast conserving surgery.Methods:85 patients with early MC breast undergoing conserving surgery in our hospital were selected and divided into two groups according to their wishes.The observation group(43 patients) received RSIM treatment and the control group(42 patients) received routine breast conserving surgery.The operation conditions(operation time, intraoperative blood loss),complication rate, aesthetic effect(scar, depression degree, difference of breast compliance, symmetry, lateral offset distance of nipple, skin color, vertical offset distance of nipple, texture and elasticity) and sociopsychological adaptation level(psycho social adaptability evaluation questionnaire) were compared between the two groups.Results:There was no significant difference in operation time and blood loss between the two groups(P>0.05).Two months after the operation, the scores of scar(2.64±0.38),degree of depression(2.59±0.37),symmetry(2.71±0.42),lateral offset distance of nipple(3.03±0.41)and longitudinal offset distance of nipple(2.98±0.36)in the observation group were lower than those in the control group[(3.17±0.42),(3.14±0.35),(3.20±0.43),(3.56±0.42),(3.25±0.40)](P<0.05),while there was no significant difference between the two groups in terms of breast compliance, skin color, texture and elasticity scores(P>0.05).The incidence of hematoma formation and skin shrinkage in the observation group was lower than that in the control group(P<0.05).Two months after the operation, the scores of anxiety/depression(28.12±3.05),attitude(33.79±4.08),self-esteem/self acceptance(33.54±2.67)and self-efficacy(33.26±1.94)in the observation group were higher than those in the control group[(18.14±2.63),(25.12±3.66),(24.07±3.11)and(26.05±2.13)](P<0.05).Conclusion:RSIM can not only reduce the complications and improve the aesthetic effect of breast, but also improve the psychosocial ad
作者 李利飞 陈秀春 焦德闯 梅小强 LI Lifei;CHEN Xiuchun;JIAO Dechuang;MEI Xiaoqiang(The Second Department of General Surgery,The Traditional Chinese Medicine Hospital of Xinmi City,Henan 452300,China)
出处 《淮海医药》 CAS 2022年第6期560-564,共5页 Journal of Huaihai Medicine
关键词 乳腺肿瘤 保乳术 乳房成形术 球拍形切口 Mammary cancer Breast conserving surgery Mammaplasty Racket-shaped incision
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