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目的探讨钠米炭混悬液不同注射部位对乳腺癌腋窝淋巴结的示踪效果及其对乳腺癌改良根治术安全性的影响。方法收集绵阳市中心医院2012年3月至2013年5月期间行乳腺癌改良根治术的乳腺癌患者88例,按入院日期分为乳晕组(n=44)和肿瘤周缘组(n=44)。术前麻醉诱导后,乳晕组于乳晕区注入钠米炭,肿瘤周缘组于肿瘤周缘注入。比较2组患者的淋巴结检出数量、转移淋巴结检出数量、淋巴结黑染率及手术效果相关指标。结果乳晕组共检出淋巴结1 453枚,其中黑染淋巴结的数量为1 396枚(96.1%);淋巴结检出数量为(33.0±7.1)枚/例;19例(43.2%)检出转移淋巴结220枚,转移淋巴结检出数量为(5±2)枚/例;手术时间为(122.1±10.2)min,术中出血量为(83.8±10.1)mL,术后住院时间为(7±1)d,术后有3例患者(6.8%)发生并发症。肿瘤周缘组共检出淋巴结909枚,其中黑染淋巴结的数量为594枚(65.3%);淋巴结检出数量为(20.7±3.2)枚/例;20例(45.5%)检出转移淋巴结88枚,转移淋巴结检出数量为(2±1)枚/例;手术时间为(121.6±11.4)min,术中出血量为(84.2±11.3)mL,术后住院时间为(7±2)d,术后有3例患者(6.8%)发生并发症。乳晕组的淋巴结黑染率、淋巴结检出数和转移淋巴结检出数均高于肿瘤周缘组(P<0.01),而2组手术时间、术中出血量、术后住院时间及术后并发症发生率的差异均无统计学意义(P>0.05)。结论麻醉诱导后于乳晕区注射纳米炭混悬液方法的淋巴示踪效果明显优于肿瘤周缘注射法,而且不增加手术并发症发生率,值得推广。
Objective To investigate the tracing effect of sodium citicum suspension injection on axillary lymph nodes in breast cancer and its effect on the safety of modified radical mastectomy for breast cancer. Methods Eighty-eight patients with breast cancer who underwent modified radical mastectomy between March 2012 and May 2013 in Mianyang Central Hospital were divided into areola group (n = 44) and tumor peripheral group (n = 44) . Preoperative anesthesia induction, the areola group in the arena area into the sodium-carbon charcoal, the tumor peripheral margin of the tumor around the injection. The number of lymph nodes, the number of metastatic lymph nodes, the rate of lymph node black staining and the related indexes of operative effect were compared between the two groups. Results A total of 1 453 lymph nodes were detected in the areola group, of which 1 396 (96.1%) were detected with black stained lymph nodes. The number of detected lymph nodes was (33.0 ± 7.1) / cases and 19 (43.2%) were detected with metastatic lymph nodes 220, and the number of metastatic lymph nodes was (5 ± 2) pieces / case. The operation time was (122.1 ± 10.2) min, the blood loss was (83.8 ± 10.1) mL and the postoperative hospital stay was (7 ± 1) d, postoperative complications occurred in 3 patients (6.8%). A total of 909 lymph nodes were detected in the tumor peripheral edge group, of which 594 (65.3%) were black-stained lymph nodes. The number of detected lymph nodes was (20.7 ± 3.2) pieces / case. Twenty (45.5% , The number of metastatic lymph nodes was (2 ± 1) pieces / case; the operative time was (121.6 ± 11.4) min, the bleeding volume was (84.2 ± 11.3) mL, the postoperative hospital stay was (7 ± 2) Postoperative complications occurred in 3 patients (6.8%). The number of nodules, the number of detected lymph nodes and the number of metastatic lymph nodes in the areola group were higher than those in the peripheral group (P <0.01), while the operation time, blood loss, postoperative hospital stay and postoperative complications There was no significant difference in incidence (P> 0.05). Conclusion Lymphatic tracing by injection of nanocarbon suspension in the areolar area after induction of anesthesia is obviously better than that of peritumoral injection and does not increase the incidence of complications. It is worth popularizing.