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目的探讨前哨淋巴结活检及腋窝淋巴结清扫术对老年早期乳腺癌患者肩部功能的影响。方法回顾性分析我院近年来手术治疗的老年早期乳腺癌患者的临床资料,根据手术方法不同分为观察组和对照组,对比分析两组患者术后肩关节活动度、肩关节功能损伤程度等。结果两组患者均顺利完成手术及术后1年的复查,均未发现复发病例。观察组患者术后Neer肩关节功能评分平均(87.6±5.8)分,对照组为(75.6±9.8)分,观察组术后Neer肩关节功能评分明显高于对照组(P<0.01),观察组肩关节功能优良率也明显高于对照组(P<0.01)。两组患者术前活动度无显著性差异(P>0.05),观察组术后屈曲、外展、后伸、外旋、内旋功能的损伤程度均明显低于对照组(P<0.01)。结论前哨淋巴结活检预测老年早期乳腺癌有无转移是安全可行的,且能明显减轻传统腋窝淋巴结清扫手术带来的肩部功能伤害;同时对减轻老年患者心理压力,提高生存质量具有重要的意义。
Objective To investigate the effect of sentinel lymph node biopsy and axillary lymph node dissection on shoulder function in elderly patients with early stage breast cancer. Methods The clinical data of elderly patients with early-stage breast cancer undergoing surgical treatment in our hospital were retrospectively analyzed. According to the different surgical methods, the patients were divided into observation group and control group. The shoulder mobility, the degree of shoulder joint injury, etc. were compared between the two groups . Results The two groups of patients were successfully completed the operation and 1 year after the review, did not find any recurrence. The score of Neer’s shoulder joint function in the observation group was (87.6 ± 5.8) points after surgery and (75.6 ± 9.8) points in the control group. The score of Neer’s shoulder joint function in the observation group was significantly higher than that of the control group (P0.01) The excellent and good rate of shoulder function was also significantly higher than that of the control group (P <0.01). There was no significant difference in preoperative activity between the two groups (P> 0.05). The degree of postoperative injury of flexion, abduction, extension, external rotation and internal rotation in the observation group were significantly lower than those in the control group (P <0.01). Conclusion Sentinel lymph node biopsy can predict the early stage of breast cancer with metastasis is safe and feasible, and can significantly reduce the traditional axillary lymph node dissection shoulder function injury; the same time to reduce the psychological stress in elderly patients, improve the quality of life of great significance.