乳腔镜辅助腋窝淋巴结清扫手术对乳腺癌患者上肢功能及生活质量的影响

目的 探讨乳腔镜辅助腋窝淋巴结清扫手术对乳腺癌患者上肢功能及生活质量的影响,为治疗乳腺癌提供参考。 方法 选取2010年6月-2013年6月肿瘤外科就诊的早期乳腺癌患者172例为研究对象,根据入院时间分为乳腔镜下腋窝淋巴结清扫术组和常规腋窝淋巴结清扫术组各86例,比较2组手术指标、上肢功能、生活质量。 结果 观察组术中出血量、腋窝引流量明显低于对照组[(65.42±7.37) ml vs.(185.53±22.86) ml,(114.25±35.06) ml vs.(188.79±48.13) ml],t=46.375、11.609,P<0.05;随访6个月,观察组肩关节前屈、后伸、内收、外展、内旋、外旋等角度均明显高于对照组(t=27.689、5.339、4.176、16.805、9.269、9.395,均P<0.05),观察组患者术后患肢感觉异常等并发症发生率(10.47%)明显低于对照组(40.70%,χ2=20.645,P<0.05),认知功能、躯体功能、社会角色功能、情绪功能等生活质量评分均明显高于对照组(t=25.998、7.213、6.439、5.551,均P<0.05)。 结论 乳腔镜辅助腋窝淋巴结清扫术有助于减轻手术创伤,促进上肢功能恢复,提高生活质量。 

Effect of mastoscopy assisted axillary lymph node dissection surgery on upper limb function and quality of life of patients with breast cancer

Objective To investigate the effect of mastoscopy assisted axillary lymph node dissection(ALND) surgery on upper limb function and quality of life of patients with breast cancer, and provide reference for treatment of breast cancer. Methods Total 172 cases early breast cancer in our department between June, 2010 and June, 2013 were enrolled and assigned into mastoscopic axillary lymph node dissection group(observational group) and conventional axillary lymph node dissection group(control group) with 86 cases in each group. The operation indicators, upper limb function and the quality of life were compared between the two groups. Results The amount of intraoperative bleeding and volume of axillary drainage in the observational group was significantly lower than that of the control group[(65.42±7.37 vs. 185.53±22.86)ml, (114.25±35.06 vs. 188.79±48.13)ml, respectively], t=46.375, 11.609, P<0.05; The 6-month follow-up showed that the angle of shoulder flexion, extension, adduction, abduction, pronation, and external rotation in the observational group were significantly greater than those in the control group(t=7.689, 5.339, 4.176, 16.805, 9.269 and 9.395, P<0.05); The incidence of complications such as limb paresthesia was 10.47% in the observational group, which was significantly lower than 40.70% in the control group (χ2=20.645, P<0.05). The scores of cognitive function, physical function and other quality of life in the observational group were significantly higher than those in the control group (t=5.998, 7.213, 6.439, 5.551, P<0.05). Conclusion Mastoscopy assisted axillary lymph node dissection is helpful to reduce the trauma, promote the recovery of upper limb function, improve the quality of life.