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目的 探讨保留胸大、小肌改良乳腺癌根治术的临床疗效。方法 回顾性分析 2 14例乳腺癌 (Ⅰ期 6 6例 ,Ⅱ期 14 1例 ,Ⅲ期 7例 )施行保留胸大、小肌改良乳腺癌根治术的治疗结果。结果 2 14例患者中术后发生皮下积液 12例 (5 6 % ) ,皮缘坏死 16例 (7 4 % ) ,上肢淋巴性水肿 8例(3 7% ) ,胸肌挛缩伴同侧上臂运动障碍 11例 (5 1% )。 3年生存率为 82 3% ,5年生存率为 6 3 4 % ,其中Ⅰ期 5年生存率为 79 6 % ,Ⅱ期 5年生存率为 5 6 3%。结论 重视保护胸外侧支神经可避免胸肌挛缩导致的上臂运动障碍 ,重视术后早期化疗能有效地预防复发和转移 ,重视创面综合处理可减少皮下积液 ,重视加强术后综合治疗可提高远期疗效
Objective To investigate the clinical effect of preserving the thoracic and maxillary muscles to improve radical mastectomy. Methods A retrospective analysis of 2 14 cases of breast cancer (Ⅰ 6 6 cases, Ⅱ 14 cases, Ⅲ 7 cases) to preserve the chest, small muscle modified radical mastectomy results. Results In 14 of 14 patients, subcutaneous fluid was found in 12 patients (56%), skin necrosis in 16 patients (74%), upper extremity lymphedema in 8 patients (37%), and contracted pectoralis contractions with ipsilateral upper arm movement disorder Eleven patients (51%). The 3-year survival rate was 82.3% and the 5-year survival rate was 63.4%. The 5-year survival rate of stage Ⅰ was 79.6% and the 5-year survival rate of stage Ⅱ was 56.3%. Conclusion Emphasis on the protection of the lateral thoracic nerve can prevent the upper limb movement disorders caused by the contracture of the pectoralis major. It is important to pay attention to the early postoperative chemotherapy to prevent recurrence and metastasis effectively. It is important to pay attention to the comprehensive treatment of the wound to reduce the subcutaneous effusion, and to emphasize the postoperative comprehensive treatment to improve the long- Efficacy