乳房整形术用于中青年早期乳腺癌保乳术后的效果及对患者生命质量的影响研究

来源:用户上传      作者:胡桂芳 罗涛 孙绍琼 吴艳军 雷永兰

　　[摘要]目的：探乳腺外科整形修复术应用于早期中青年乳腺癌保乳手术患者的效果及对患者婚姻质量、创伤反应影响。方法：选取2018年6月-2020年3月笔者医院100例早期青年乳腺癌患者，根据手术方案分组，各50例。对照组行保乳手术，实验组行保乳手术+乳腺外科整形修复术。观察两组围术期情况、并发症、乳房美容效果及手术前后肿瘤标志物、婚姻质量（ENRICH）、创伤反应。结果：实验组术中出血量、住院时间、术中切缘阴性率均优于对照组，手术时间、切除乳腺体积均大于对照组，差异有统计学意义（P<0.05）。术后1d、3d两组血清IL-6、Cor、CRP水平高于术前（P<0.05）。术后3个月后两组血清miR-638水平高于术前，CA153、TSGF水平低于术前（P<0.05）。术后3个月实验组婚姻满意度、夫妻性生活、夫妻交流评分高于对照组（P<0.05）。两组并发症发生率比较无显著差异（P>0.05）。实验组乳房美学效果优于对照组（P<0.05）。结论：乳腺外科整形修复术应用于早期青年乳腺癌保乳手术患者，有助于减少术中出血量，缩短住院时间，减轻创伤反应，提高乳房美学效果，改善婚姻质量。
　　[关键词]青年乳腺癌;早期;乳腺外科整形修复术;保乳手术;婚姻质量;创伤反应
　　[中图分类号]R737.9 [文献标志码]A [文章编号]1008-6455（2022）03-0072-04
　　Effect of Breast Reconstruction on Breast Conserving Surgery for Young and Middle-Aged Patients with Early Breast Cancer and Its Influence on Life Quality
　　HU Guifang1，LUO Tao2，SUN Shaoqiong1，WU Yanjun2，LEI Yonglan3
　　（1.Operating Room，Panzhihua Central Hospital，Panzhihua 610000，Sichuan，China; 2.Department of General Surgery，Panzhihua Central Hospital，Panzhihua 617000，Sichuan，China;3.Department of Laboratory Medicine，Panzhihua Central Hospital，Panzhihua 617000，Sichuan，China）
　　Abstract： Objective To investigate the effect of breast reconstruction were applied to young patients with early breast cancer breast-conserving surgery and its influence on the marital quality and trauma response of patients. Methods A total of 100 early-stage young breast cancer patients in our hospital from June 2018 to March 2020 were selected and grouped according to the surgical plan， with 50 cases in each group. The control group received breast-conserving surgery， while the experimental group received breast-conserving surgery + breast surgery. The perioperative conditions， complications， breast cosmetic effects， tumor markers， marital quality （ENRICH）， and trauma response before and after surgery were observed in the two groups. Results The amount of intraoperative blood loss， hospital stay， and negative rate of intraoperative margins in the experimental group were better than those in the control group， and the operation time and the volume of the removed breast were greater than those in the control group， with statistically significant differences （P<0.05）. 1d and 3d after operation， the serum levels of IL-6， Cor and CRP in the two groups were higher than those before operation （P<0.05）. 3 months after operation， the serum levels of miR-638 in the two groups were higher than those before operation， and the levels of CA153 and TSGF were lower than those before operation （P<0.05）. The scores of marital satisfaction， marital sex life， and marital communication in the experimental group were higher than those in the control group 3 months after surgery （P<0.05）. There was no significant difference in the incidence of complications between the two groups （P>0.05）. The breast beauty effect of the experimental group was better than that of the control group （P<0.05）. Conclusion Breast reconstruction is applied to early-stage young breast cancer patients with breast-conserving surgery， which helps to reduce intraoperative blood loss， shorten hospital stay， reduce trauma reaction， improve breast cosmetic effect， and improve marital quality.

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