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目的探讨保留乳头乳晕的改良根治术联合假体置入术对早期乳腺癌患者乳房重建的意义,并观察其生存质量、并发症。方法方便选取2014年9月—2016年9月该院收治的128例绝经期早期乳腺癌患者,其中118例为Ⅰ期患者,10例为Ⅱ期患者。按照手术方法的不同分为观察组(50例)和对照组(78例),观察组行保留乳头乳晕的改良根治术联合假体即刻置入术,对照组行传统改良根治术。术后3个月对乳房外观、生活质量以及术后并发症的情况进行评价。结果术后3个月对两组患者的乳房外观评价结果:观察组患者的乳房外观优良率达96.00%显著高于对照组的乳房外观优良率为66.67%,差异有统计学意义(χ~2=14.90,P<0.05)。3个月后的两组患者生活质量评分结果显示:观察组为(156.43±21.95)分显著高于对照组(101.32±20.53)分,差异有统计学意义(χ~2=11.567,P<0.05)。术后并发症数据结果:观察组的术后皮瓣坏死、创面渗液、淋巴水肿的发生率分别为12.00%、34.00%、2.00%,对照组的术后皮瓣坏死、创面渗液、淋巴水肿的发生率分别为11.54%、42.31%、3.85%,两组数据的统计学分析结果显示,两组的并发症发生率差异无统计学意义(χ~2=1.358,P>0.05)。结论保留乳头乳晕改良根治术联合假体置入术在临床治疗绝经期早期乳腺癌患者中的应用时有显著的临床效果,且患者的临床获益大大提高,值得推广使用。
Objective To investigate the significance of modified radical mastectomy combined with prosthesis implantation for breast reconstruction in patients with early breast cancer and to observe the quality of life and complications. METHODS: A total of 128 patients with early-stage menopause of breast cancer were enrolled in this hospital from September 2014 to September 2016, of which 118 were stage Ⅰ and 10 were stage Ⅱ. According to the different surgical methods, the observation group (50 cases) and the control group (78 cases) were divided into two groups. The observation group received modified radical mastectomy with nipple areola immediately and the control group received conventional modified radical mastectomy. The appearance of the breast, quality of life, and postoperative complications were evaluated 3 months after surgery. Results The evaluation of breast appearance of the two groups at 3 months after operation showed that the excellent and good rate of breast appearance in observation group was 96.00%, which was significantly higher than that of control group (66.67%), the difference was statistically significant (χ ~ 2 = 14.90, P <0.05). The quality of life score of two groups after 3 months showed that the score of the observation group was (156.43 ± 21.95) points higher than that of the control group (101.32 ± 20.53) points, the difference was statistically significant (χ ~ 2 = 11.567, P <0.05 ). Results of postoperative complication data: The incidences of postoperative flap necrosis, exudate and lymphedema in the observation group were 12.00%, 34.00% and 2.00% respectively. The postoperative flap necrosis, wound exudate and lymph The incidence of edema was 11.54%, 42.31% and 3.85% respectively. The statistical analysis of the two groups showed no significant difference in the incidence of complications (χ ~ 2 = 1.358, P> 0.05). CONCLUSION: The preservation of nipple areola modified radical mastectomy combined with prosthesis implantation in the clinical treatment of patients with early stage breast cancer in menopause has significant clinical effect, and the clinical benefit of patients greatly increased, it is worth promoting the use of.