保留乳头乳晕改良根治术治疗早期乳腺癌的效果分析

张兰 谢竞 付琳琳

郑州大学附属郑州市中心医院乳腺外科

摘要：目的：探讨保留乳头乳晕改良根治术（NSM）治疗早期乳腺癌（EBC）的效果。方法：选取113例EBC患者，按照随机数字表法分为对照组56例和干预组57例。对照组给予传统乳腺癌改良根治术（MRM）治疗，干预组57例给予NSM治疗。对比两组手术情况、乳房美容效果、免疫功能和激素水平。结果：两组淋巴结清扫数目、手术时间比较差异无统计学意义（P＞0.05）,干预组住院时间短于对照组，术后引流量少于对照组（P＜0.05）;干预组美容优良率94.74%高于对照组80.36%（P＜0.05）;术后1个月，两组血清FT3、FT4水平较术前升高，且干预组高于对照组（P＜0.05）;术后1 d,两组CD3+、CD4+、CD4+/CD8+水平较术前降低，干预组高于对照组（P＜0.05）。结论：NSM治疗EBC患者可改善手术情况和免疫功能，也有良好的乳房美容效果。

关键词：保留乳头乳晕改良根治术;早期乳腺癌;免疫功能;

Effect of modified nipple-sparing radical mastectomy on patients with early breast cancer

ZHANG Lan,XIE Jing,FU Linlin.(Dept. of Breast Surgery,the Affiliated Zhengzhou Central Hospital of Zhengzhou University,Zhengzhou 450000,China)

Abstract Objective: To investigate the effect of modified nipple-sparing radical mastectomy(NSM) on patients with early breast cancer ( EBC). Methods: A total of 113 EBC patients were selected and randomized into two groups, with 56 cases in the control group and 57 cases in the intervention group. The control group were treated with traditional modified radical mastectomy ( MRM), while the intervention group were treated with NSM. Then, the operation, breast cosmetic effect, immune function and hormone level of the patients were compared between both groups. Results: There was no difference in the number of lymph node dissection and operation time between the two groups(P>0.05); The hospitalization time of the intervention group was shorter than that of the control group, and the postoperative drainage volume was less than that of the control group(P<0.05). The beauty rate of intervention group was 94.74%, which was higher than 80.36% of the control group(P<0.05); levels of serum FT3 and FT4 in both groups were increased one month after operation, and the levels in intervention group were higher than those in control group(P< 0.05); levels of CD3+, CD4+and CD4+/ CD8+in both groups were decreased one day after operation compared with those before operation, and the intervention group was higher than that in control group(P<0.05). Conclusion: The treatment with NSM for EBC patients can not only improve the surgical outcomes and immune function, but also has good breast cosmetic effects on patients.

Keywords:modified nipple-sparing radical mastectomy ( NSM); early breast cancer ( EBC); immune function

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