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[目的]探讨早期乳腺癌患者行前哨淋巴结活检(SLNB)为阴性,行简化腋窝淋巴结清扫替代腋窝淋巴结清扫术(ALND)的临床效果。[方法]采用1%亚甲蓝染色法对65例早期乳腺癌患者行SLNB,60例成功行SLNB,其中40例SLN无转移者行简化腋窝淋巴结清扫术(简化组);20例SLN有转移者行ALND(标准组),比较两组患者术后上肢并发症的发生情况、腋窝复发及全身转移情况。[结果]简化组手术时间和腋窝引流时间比标准组明显缩短,有统计学差异(P<0.01);简化组术后患侧上肢的疼痛、肿胀、麻木症状明显较标准组少(P<0.01)。两组生存曲线没有差异。[结论]亚甲蓝染色法能够比较准确地定位乳腺癌的前哨淋巴结。简化ALND替代ALND手术时间和术后引流时间缩短,方便可行,并发症明显减少,腋窝复发率低,是早期乳腺癌患者的安全分期手术。
[Objective] To investigate the clinical efficacy of simplified axillary lymph node dissection (ALND) in patients with early-stage breast cancer who underwent SLNB (negative sentinel lymph node biopsy). [Method] SLNB was performed in 65 cases of early-stage breast cancer patients by 1% methylene blue staining and 60 cases of SLNB were successfully treated. 40 cases of SLN without metastasis underwent simplified axillary lymph node dissection (simplified group); 20 cases of SLN had metastasis The patients underwent ALND (standard group). The incidence of postoperative upper limb complications, axillary recurrence and systemic metastasis were compared between the two groups. [Results] The time of operation and axillary drainage time in the simplified group were significantly shorter than those in the standard group (P <0.01). The pain, swelling and numbness symptoms of the affected side of the simplified group were significantly less than those in the standard group (P <0.01) ). There was no difference in survival curves between the two groups. [Conclusion] The methylene blue staining method can locate the sentinel lymph node of breast cancer more accurately. Simplified ALND ALND ALND operation time and drainage time shortened, convenient and feasible, significantly reduced complications, low recurrence rate of axilla, breast cancer in patients with early stage staging.