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目的调查不同手术方法(保乳手术、根治手术以及保乳或根治术后的重建手术)的乳腺癌患者术后的生活质量以及满意度。方法选择自2005年1月至2006年10月在德国汉诺威医科大学附属医院妇女保健中心接受手术治疗的乳腺癌患者共180例,分别给予调查问卷,包括EORTC QLQ-C30、EORTC QLQ-BR23以及自行设计的关于对术后外形满意度的问卷。所有患者在被调查时均没有局部和远处的转移。结果112例(62.2%)回信患者中,保乳组、根治组以及重建组各76、20、16例,保乳组患者较根治组和重建组有较好的身体映像(BI)(P=0.004,P=0.003),重建组患者比保乳组有较大的经济困难(FD)(P=0.006)和较多的对前景的看法(FP)(P=0.039);保乳组患者和根治组、重建组相比对术后乳房的外形有较好的自我评价(P=0.001,P<0.001)和较不明显的术后疤痕(P=0.003,P=0.019),对外形结果的满意比较显示重建组的患者认为术后双侧乳房形状的差异明显大于保乳组(P=0.005),双侧乳房大小的差异、对乳头乳晕的位置和形状是否满意方面两组之间的比较无明显的统计学意义(P=0.077,P=0.272)。结论和根治组以及重建组相比较,保乳组的患者有较好的术后生活质量和满意度。
Objective To investigate the postoperative quality of life and satisfaction of breast cancer patients under different surgical methods (breast-conserving surgery, radical surgery and reconstructive surgery after breast-conserving or radical surgery). Methods A total of 180 breast cancer patients undergoing surgical treatment at the Women’s Health Center, Hannover Medical University Hospital, Hanover, Germany, from January 2005 to October 2006 were surveyed and included questionnaires including EORTC QLQ-C30, EORTC QLQ-BR23 and their own Design questionnaire about postoperative shape satisfaction. None of the patients underwent local and distant metastases when investigated. Results Among 112 cases (62.2%) of the respondents, there were 76, 20, and 16 cases of breast conserving group, radical group and reconstruction group respectively. The breast conserving group had better body image (BI) than the radical group and reconstruction group (P = 0.004, P = 0.003). Patients in the reconstructed group had greater financial difficulties (FD) (P = 0.006) and more prospective patients (FP) than those in the conservative group (P = 0.039) (P = 0.001, P <0.001) and the less obvious postoperative scar (P = 0.003, P = 0.019) compared with the radical group and the reconstruction group Satisfactory comparisons showed that patients in the reconstructed group concluded that postoperative differences in bilateral breast shape were significantly greater than those in the preservation group (P = 0.005), bilateral breast size differences, and satisfaction with nipple areola position and shape No significant statistical significance (P = 0.077, P = 0.272). Conclusion Compared with the radical group and the reconstruction group, the patients in the breast-conserving group had better postoperative quality of life and satisfaction.