【摘要】 目的分析前哨淋巴结活检与腋窝淋巴结清扫术对早期乳腺癌患者术后恢复、并发症及免疫功能的影响。方法前瞻性选取2016年3月至2019年10月入住六安市中医院的100例早期乳腺癌患者,按随机数字表法分为观察组和对照组50例。观察组患者予以乳房切除术联合前哨淋巴结活检,对照组予以乳房切除术联合腋窝淋巴结清扫术。记录并比较2组患者恢复情况、术前及术后6个月免疫功能指标水平、生活质量以及并发症的发生率。结果术后6个月,观察组上臂周径、肩关节活动度分别为(34.26±4.28) cm、(121.53±24.18)°均显著优于对照组[(29.49±4.19)cm、(70.69±11.57)°],差异均有统计学意义(P <0.05),观察组患者上肢功能障碍发生率为8.00%明显低于对照组的32.00%,差异有统计学意义(P <0.05);术后6个月,观察组患者CD3~+、CD4~+、CD4~+/CD8~+含量分别为(72.73±14.15)%、(48.05±10.56)%、2.68±1.46、明显高于对照组[(58.46±16.74)%、(42.59±9.57)%、1.64±0.75],CD8~+含量(22.29±6.42)%低于对照组[(26.19±6.54)%],差异均有统计学意义(P <0.05);术后6个月,2组患者生活质量评分均高于治疗前,差异有统计学意义(P <0.05);观察组患者并发症的发生率为10%明显低于对照组的32.00%,差异有统计学意义(P <0.05)。结论前哨淋巴结活检应用于早期乳腺癌患者效果更好,有利于促进术后恢复,改善免疫功能,提高术后生活质量并降低并发症的发生率。更多还原

【Abstract】 Objective To analyze the effects of sentinel lymph node biopsy and axillary lymph node dissection on postoperative recovery,complications and immune function of patients with early breast cancer. Methods From March 2016 to October 2019,100 patients with early breast cancer who were admitted to Lu’an City Hospital of Traditional Chinese Medicine were prospectively selected and divided into observation group and control group with 50 cases by random number table. Patients in observation group were given radical mastectomy combined with sentinel lymph node biopsy,while patients in control group were given radical mastectomy combined with axillary lymph node dissection. The recovery,immune function index level,quality of life and complication rate of the two groups were recorded and compared. Results After operation,the circumference of upper arm and the range of motion of shoulder joint in the observation group were (34. 26 ± 4. 28) cm and (121. 53 ± 24. 18) °,respectively,significantly better than those in the control group [ (29. 49 ± 4. 19) cm, (70. 69 ± 11. 57) °],the differences were statistically significant (P < 0. 05),and the incidence of upper limb dysfunction in the observation group was 8. 00%,which was significantly lower than that in the control group (P < 0. 05). The ratio of CD3~+,CD4~+ and CD4~+/CD8~+ in the observation group was (72. 73 ± 14. 15) %, (48. 05 ±10. 56) %,2. 68 ± 1. 46,which was significantly higher than that in the control group [ (58. 46 ± 16. 74) %, (42. 59 ± 9. 57) %,1. 64 ± 0.75 ],the ratio of CD8~+ (22. 29 ± 6. 42) % was lower than in the control group [ (26. 19 ± 6. 54) % ],the difference was statistically significant(P < 0. 05). Six months after operation,the quality of life scores of patients in both groups were higher than those before treatment,the differences were statistically significant (P < 0. 05). The incidence of complications in the observation group was 10%,which was significantly lower than that in the control group (32. 00%),the difference was statistically significant (P < 0. 05). Conclusion Sentinel lymph node biopsy is effective in early breast cancer patients,which is beneficial to promote postoperative recovery,improve immune function,improve postoperative quality of life and reduce the incidence of complications.更多还原