保留乳头乳晕的改良根治术联合假体置入术对乳腺癌早期患者的影响观察

目的探讨保留乳头乳晕的改良根治术联合假体置入术对乳腺癌早期患者应对方式及美观效果的影响。 方法选取2017年3月至2019年3月长安医院收治的乳腺癌早期患者140例，根据手术方案分为研究组与对照组，各70例。研究组采取保留乳头乳晕的改良根治术联合假体置入术，对照组采取乳腺癌改良根治术。统计两组手术情况（手术时间、淋巴结清扫数目、术后引流量、住院时间）、并发症（皮下气肿、感染、皮肤坏死、皮下积液、上肢水肿）、美观效果，对比手术前后免疫功能（CD3⁺、CD4⁺、CD4⁺/CD8⁺）、应对方式。 结果研究组术后引流量少于对照组，住院时间短于对照组（t=13.584、8.423，P<0.001、<0.001）。术后1 d研究组CD3⁺、CD4⁺、CD4⁺/CD8⁺高于对照组（t=6.612、7.057、5.170，均P<0.001）。术后1个月研究组依靠自我、姑息、宿命、逃避评分低于对照组，情感宣泄、寻求支持、乐观、面对评分高于对照组（t=10.821、11.010、7.854、5.952、8.563、9.657、9.223、11.596，均P<0.001）。研究组并发症发生率（5.72%）低于对照组（20.00%）（χ²=6.375，P=0.012），美观效果优良率（92.86%）高于对照组（81.43%）（χ²=4.080，P=0.043）。 结论保留乳头乳晕的改良根治术联合假体置入术治疗乳腺癌早期患者，可减少并发症，改善应对方式，提高美观效果，且对免疫功能影响较小。

Effect of improved radical surgery for preserving nipple and areola combined with prosthesis implantation on early breast cancer patients

ObjectiveTo investigate the effect of modified radical operation for preserving nipple and areola combined with prosthesis implantation on coping style and aesthetic effect of patients with early breast cancer. MethodsA total of one hundred and forty early breast cancer patients treated in Chang’an Hospital from March 2017 to March 2019 were selected and divided into study group and control group, with 70 cases in each group. The study group adopted modified radical operation for preserving nipple and areola combined with prosthesis implantation, while the control group underwent modified radical mastectomy for breast cancer. The operation time, number of lymph node dissection, postoperative drainage and hospitalization time, complications (subcutaneous emphysema, infection, skin necrosis, subcutaneous effusion, upper limb edema), aesthetic effect, immune function (CD3⁺, CD4⁺, CD4⁺/CD8⁺) and coping style before and after operation were compared between the two groups. ResultsThe postoperative drainage volume of the study group was less than that of the control group, and the hospital stay was shorter than that of the control group (t=13.584, 8.423, P<0.001, <0.001). CD3⁺, CD4⁺, and CD4⁺/CD8⁺ of the study group were higher than those of the control group one day after operation (t=6.612, 7.057, 5.170, all P<0.001). One month after surgery, the scores of self-reliance, palliative care, fatalism and escape in the study group were lower than those in the control group, while the scores of emotional catharsis, support seeking, optimism and face-to-face in the study group were higher than those in the control group (t=10.821, 11.010, 7.854, 5.952, 8.563, 9.657, 9.223, 11.596, all P<0.001). The incidence of complications in the study group (5.72%) was lower than that in the control group (20.00%) (χ²=6.375, P=0.012). The excellent rate of aesthetic effect in the study group (92.86%) was higher than that in the control group (81.43%) (χ²=4.080, P=0.043). ConclusionNipple and areola-preserving combined radical mastectomy combined with prosthesis implantation can reduce complications, improve coping styles and aesthetic effects, and have less impact on immune function.