摘要
目的对比分析乳腺癌患者接受前哨淋巴结活检(SLNB)与腋窝淋巴清扫(ALND)术后的生活质量。方法选择山东省肿瘤医院乳腺病中心2004年1月至2006年12月期间收治的591例乳腺癌患者,均符合SLNB的适应证,无上肢关节、血管神经疾病和颈椎疾病,分为SLNB组(n=339)和ALND组(n=252)。结果①SLNB组上臂周径在术后第1、2、3周时均与术前接近(分别P=0.232、P=0.318及P=0.415);ALND组在术后第1、2周时均明显大于术前(分别P=0.011和P=0.041),第3周时与术前接近(P=0.290)。②SLNB组肩关节最大外展角度在术后第1、2周时均明显小于术前(分别P=0.031和P=0.043),第3周时恢复至术前水平(P=0.196);ALND组在术后第1、2、3周时均明显小于术前(均P<0.001)。③ALND组接受保乳手术和接受乳腺切除术的患者的引流管留置时间均明显长于SLNB组接受乳腺切除术的患者(均P<0.001)。④ALND组患者术后感染、上肢感觉功能障碍的发生率均明显高于SLNB组(分别P=0.002和P<0.001)。结论前哨淋巴结阴性患者,SLNB替代ALND可以明显降低术后并发症,改善患者的生活质量,缩短住院时间并降低医疗费用。
Objective To evaluate the quality of life after sentinel lymph node biopsy（SLNB） in patients with breast cancer.Methods From January 2004 to December 2006,591 patients with breast cancer who were suitable for SLNB were divided into SLNB group（n=339） and axillary lymph node dissection（ALND） group（n=252）.All patients didn＇t have the upper extremity joints disease,the vascular nerve disease,and the cervical spondylosis previously.Results ①In patients with SLNB,the circumferences of upper arm in one,two,and three weeks after operation were similar to those before operation（P=0.232,P=0.318,and P=0.415,respectively）.While,in patients with ALND,the circumferences of upper arm in one or two weeks after operation were significantly bigger than those before operation（P=0.011,P=0.041,respectively）,and the circumference in three weeks after operation was similar to that before operation（P=0.290）.②In patients with SLNB,the outreach angles of shoulder joint in one and two weeks after operation were significantly smaller than those before operation（P=0.031,P=0.043,respectively）,and the angle in three weeks after operation was similar to that before operation（P=0.196）.However,in patients with ALND,the angles in one,two or three weeks after operation were significantly smaller than those before operation（all P0.001）.③The retention time of drainage tube in patients with ALND who received breast conserving surgery or mastectomy was significantly longer than that in patients with SLNB who received mastectomy（all P0.001）.④The infection rate and the sensory disjunction rate in patients with ALND were significantly higher than those in patients with SLNB（P=0.002,P0.001,respectively）.Conclusions For patients with lymph node negative breast cancer,SLNB could decrease postoperative complications,and improve the quality of life.It could also save money by reducing hospital stay.
出处
《中国普外基础与临床杂志》
CAS
2011年第9期922-925,共4页
Chinese Journal of Bases and Clinics In General Surgery
关键词
乳腺癌
前哨淋巴结活检术
生活质量
Breast cancer
Sentinel lymph node biopsy
Quality of life
