改良根治术与早期乳腺癌保乳手术的疗效及对患者创伤后应激障碍发生的影响

目的探讨改良根治术与保乳手术对于早期乳腺癌患者的临床疗效和对患者创伤后应激障碍发生的影响。方法选取行手术治疗90例的早期乳腺癌患者作为研究对象,在经过患者及家属同意的情况,按患者意愿分为改良根治术组(50例)和保乳术组(40例),分别行两种治疗方式。比较两组患者手术时间、术中出血量、术后引流量、住院时间、并发症发生率、术后美容效果、生存率、复发率、远处迁移率和创伤后应激障碍筛查量表(PCL-C)评分。结果保乳术组与改良根治术组相比,手术时间、住院时间显著更短(P<0.01),术中出血量、术后引流量显著更少(P<0.01),并发症发生率更低(P<0.05),术后乳房美容效果更好(P<0.01),术后1年生存率、复发率和远处迁移率无统计学差异(P>0.05)。创伤后应激障碍(PTSD)影响方面,平均总得分保乳术组(32.50±9.76)比改良根治术组(41.87±12.57)显著更低(P<0.01),PTSD阳性率更低(P=0.047<0.05)。结论两种治疗方法,对早期乳腺癌疗效方面在一年内没有明显区别,但不论是减少术中痛苦程度和术后患者恢复正常生活,减少心理影响方面,保乳术疗法明显更优,临床上值得推广。

Inhibitory Effect of the Steroid Saponins from the Flowers of Cestrum Nocturnum,Linn(SSFCN)on Proliferation of Leukemia K562 Cells and PI3K/AKt Pathway Regulation

Objective To explore the effect of modified radical mastectomy and breast conserving on early breast cancer patients and posttraumatic stress disorder(PTSD).Methods 90 patients with early breast cancer who underwent surgical treatment were selected as the subjects of the study,with the consent of the patients and their families.The patients were divided into modified radical operation group(n=50)and breast conserving group(n=40)according to their wishes.The operative time,intraoperative bleeding volume,postoperative drainage volume,hospitalization time,complication rate,postoperative cosmetic effect,survival rate,recurrence rate,distant migration rate and post-traumatic stress disorder screening scale(PCL-C)were compared between the 2 groups.Results Compared with the modified radical mastectomy group,the operation time and hospital stay in breast conserving group were significantly shorter(P<0.01),the intraoperative bleeding volume and postoperative drainage volume were significantly lower(P<0.01),and the incidence of complications was lower(P<0.05).The postoperative breast cosmetic effect was better(P<0.01).There was no significant difference in 1-year survival rate,recurrence rate and distant mobility(P>0.05).The average total score of posttraumatic stress disorder in breast conserving group(32.50±9.76)was significantly lower than that of modified radical mastectomy group(41.87±12.57)(P<0.01).Conclusion There is no significant difference in the curative effect of the 2 treatments for early breast cancer within one year,but breast conserving therapy is obviously better in terms of reducing the degree of pain during operation and the recovery of normal life and psychological impact of patients after operation.It is worth popularizing clinically.