CAJ | 학술논문

目的：探讨保乳手术与改良根治术治疗早期乳腺癌的效果。方法选择2007年1月~2010年1月邯郸市冀中能源峰峰集团总医院收治的乳腺癌患者45例，按患者意愿分为研究组(22例)与对照组(23例)。研究组给予保乳手术治疗，对照组给予改良根治术治疗，同时均给予腋窝淋巴结清扫术，术后常规行放疗和化疗。比较两组患者手术时间、术中出血量、住院时间、局部复发率及1、3、5年生存率。采用健康状况调查问卷(SF-36量表)进行生活质量评估并行术后乳房美容评定。结果研究组患者手术时间[(145±26)min]、术中出血量[(248±50)mL]、住院时间[(11±1)d]少于对照组[(188±31)min、(400±40)mL、(17±2)d]，差异均有统计学意义(均P<0.05)。研究组1、3、5年生存率分别为100.0%、100.0%、95.7%，对照组分别为100.0%、100.0%、95.5%，两组比较差异均无统计学意义(均P>0.05)。研究组与对照组患者局部复发率分别为4.5%与8.7%，两组比较差异无统计学意义(P>0.05)。患者术后乳房美容评定结果院研究组优19例，良2例，差1例；对照组优7例，良6例，差10例；两组比较差异有高度统计学意义(P<0.01)。研究组患者SF-36量表中的8个维度项目评分均高于对照组，差异均有统计学意义(P<0.05)。结论早期乳腺癌患者行保乳手术与改良根治术治疗效果较好，但与根治术比较，保乳手术对患者生理及心理的损害小，患者术后生活质量较高。
목적：탐토보유수술여개량근치술치료조기유선암적효과。방법선택2007년1월~2010년1월함단시기중능원봉봉집단총의원수치적유선암환자45례，안환자의원분위연구조(22례)여대조조(23례)。연구조급여보유수술치료，대조조급여개량근치술치료，동시균급여액와림파결청소술，술후상규행방료화화료。비교량조환자수술시간、술중출혈량、주원시간、국부복발솔급1、3、5년생존솔。채용건강상황조사문권(SF-36량표)진행생활질량평고병행술후유방미용평정。결과연구조환자수술시간[(145±26)min]、술중출혈량[(248±50)mL]、주원시간[(11±1)d]소우대조조[(188±31)min、(400±40)mL、(17±2)d]，차이균유통계학의의(균P<0.05)。연구조1、3、5년생존솔분별위100.0%、100.0%、95.7%，대조조분별위100.0%、100.0%、95.5%，량조비교차이균무통계학의의(균P>0.05)。연구조여대조조환자국부복발솔분별위4.5%여8.7%，량조비교차이무통계학의의(P>0.05)。환자술후유방미용평정결과원연구조우19례，량2례，차1례；대조조우7례，량6례，차10례；량조비교차이유고도통계학의의(P<0.01)。연구조환자SF-36량표중적8개유도항목평분균고우대조조，차이균유통계학의의(P<0.05)。결론조기유선암환자행보유수술여개량근치술치료효과교호，단여근치술비교，보유수술대환자생리급심리적손해소，환자술후생활질량교고。
Objective To investigate the effect of breast conserving mastectomy and modified radical mastectomy for early breast cancer. Methods 45 breast cancer patients were randomly divided into the research group (22 cases) and control group (23 cases), who were hospitalized from January 2007 to January 2010 in General Hospital of Fengfeng Group, Jizhong Energy Group Co.Ltd. The research group were treated with breast conserving mastectomy and the con-trol group were treated with modified radical mastectomy. Two groups were both treated with axillary lymph node dis-section and received conventional radiotherapy and chemotherapy after surgery. The duration of operation, intraopera-tive blood loss, length of hospital stay, local recurrence rate and 1, 3, 5 year survival rate were compared in two groups respectively. The patients' quality of life and breast appearance were evaluated with the SF-36 scale and the breast beauty evaluation respectively. Results The duration of operation [(145±26) min], intraoperative blood loss [(248±50) mL], length of hospital stay [(11±1) d] in research group were less than those in control group respectively [(188±31) min, (400±40) mL, (17±2) d], the differences were statistically significant (all P<0.05). 1, 3, 5 year survival rate in re-search group and control group were 100.0%, 100.0%, 95.7%and 100.0%, 100.0%, 95.5%respectively, the differences between the two groups had no statistical significance (all P> 0.05). The local recurrence rate in the research group and control group were 4.5% and 8.7% respectively, there was no significant difference between two groups (P> 0.05). The breast beauty evaluation in research group after surgery were as follows: excellent in 19 cases, good in 2 cases, poor in 1 cases; the control group: excellent in 7 cases, good in 6 cases, poor in 10 cases. There was significant differ-ence between two groups (P<0.01). 8 dimensions of SF-36 scale in the research group were higher than those in the control group (P< 0.05). Conclusion The effect of breast conserving mastectomy and modified radical mastectomy in treatment of early stage breast cancer is good. But compared with modified radical mastectomy, the damage to physical and mental on patients with breast conserving mastectomy is less and the quality of life is higher.