前哨淋巴结活检与腋窝淋巴结清扫术在早期乳腺癌患者的应用对比

发布时间：2018-04-09 20:11

本文选题：乳腺肿瘤　切入点：前哨淋巴结活组织检查　出处：《中国全科医学》2017年S1期

【摘要】：目的研究早期乳腺癌患者运用前哨淋巴结活检术(SLNB)与腋窝淋巴结清扫术(ALND)的临床效果,为早期乳腺癌的手术治疗提供理论依据。方法研究对象选择2014年12月—2015年12月期间于浙江省瑞安市人民医院治疗的150例早期乳腺癌患者,将经协商、会诊后采用SLNB治疗的70患者设为观察组,将80例采用ALND的患者设为对照组。均采用SF-36量表对两组患者进行术后生活质量调查,同时进行Neer肩关节功能评分以及肩关节最大外展角比较,以此评价两组患者术后肩关节功能,同时比较两组患者术后并发症发生情况,用时通过术后随访的方式比较两组患者复发及转移情况。结果两组患者SF-36量表评分比较,观察组精神健康、总体健康、生理职能、生理功能、情感职能、社会功能评分高于对照组,差异有统计学意义(P0.05),躯体疼痛、活力评分比较,差异无统计学意义(P0.05);两组患者术前与术后1周、2周、Neer肩关节功能评分、最大外展角低于术前,差异有统计学意义(P0.05);术前与术后4周比较,差异无统计学意义(P0.05)。观察组患者术后1周、2周、4周Neer肩关节功能评分高于对照组,差异有统计学意义(P0.05);观察组术后上肢麻木、上肢疼痛、活动受限发生率低于对照组,差异有统计学意义(P0.05);上肢淋巴结水肿、腋窝积液发生率与对照组比较,差异无统计学意义(P0.05)。结论 SLNB在早期乳腺癌患者的治疗中在控制术后并发症、改善上肢功能方面显著优于ALND,改善患者术后生活质量,能够替代ALND对乳腺癌腋窝淋巴结的处理。
[Abstract]:Objective to study the clinical effect of sentinel lymph node biopsy (SLNB) and axillary lymph node dissection (ALND) in patients with early breast cancer.Methods one hundred and fifty patients with early breast cancer treated in Ruian people's Hospital of Zhejiang Province from December 2014 to December 2015 were selected. 70 patients who were treated with SLNB after consultation were divided into observation group.80 patients with ALND were selected as control group.The quality of life (QOL) of the two groups was investigated with SF-36 scale, and the Neer shoulder joint function score and the maximum abduction angle of the shoulder joint were compared in order to evaluate the postoperative shoulder joint function of the two groups.At the same time, the incidence of postoperative complications was compared between the two groups, and the recurrence and metastasis of the two groups were compared by the way of postoperative follow-up.Results the scores of mental health, general health, physiological function, physiological function, emotional function and social function in the observation group were higher than those in the control group (P 0.05).There was no significant difference between the two groups (P 0.05), and there was no significant difference between the two groups in the functional score of Neer shoulder joint before operation and 1 week and 2 weeks after operation, the maximum abduction angle was lower than that before operation (P 0.05), and there was no significant difference between preoperative and postoperative 4 weeks (P 0.05).The Neer shoulder function score in the observation group was higher than that in the control group at 1 week and 2 weeks and 4 weeks after operation, the difference was statistically significant (P 0.05), and the incidence of numbness, pain and limited movement of the upper limb in the observation group was lower than that in the control group.There was no significant difference in the incidence of lymph node edema and axillary effusion between the two groups.Conclusion SLNB is superior to ALND in controlling postoperative complications and improving the function of upper limb in the treatment of early breast cancer. It can replace ALND in the treatment of axillary lymph nodes of breast cancer.
【作者单位】：浙江省瑞安市人民医院;
【分类号】：R737.9

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