| Objective:to explore the axillary lymph nodes of breast cancer were performed boc nano carbon in ensemble technique can improve the detection results and axillary lymph nodes in the axillary lymph node positive rate,and can shorten the operation time,reduce intraoperative blood loss,shorten hospitalization days and reduce postoperative days total flow rate and shorten the remoal of drainage tube,reduce the postoperative of lateral upper extremity edema,paralysis,pain and the incidence of complications such as shoulder movement disorders.Methods:retrospective cohort study was used to collect clinical and pathological data of 40 cases of breast cancer patients admitted to the second people's hospital of yunnan province from June 2016 to June 2017 according to the inclusion and exclusion criteria.All the 40 patients were treated with modified radical mastectomy,of which 20 were divided into lymph nodes by nano-carbon radiography,and were set as observation group.20 conventional lymph nodes were divided into control group.Observation indexes:(1)lymph node detection and pathological examination,as well as operation time,intraoperative blood loss,postoperative hospitalization days,total drainage flow,days of removal of drainage tube,etc.(2)follow-up.The patients were followed up by outpatient clinic and telephone.The follow-ups included:the patients' adjuvant chemotherapy,tumor recurrence and metastasis,upper limb edema,paralysis pain,shoulder lifting movement disorder and other surgical complications during the follow-up period.The follow-up period ended in June 2018.The measurement data of normal distribution were expressed as(x±S),and t test was used for inter-group comparison.The comparison of count data was performed by x2 test.Non-parametric test was used for comparison of grade data.Results:(1)lymph node detection and pathological examination:all the 40 patients successfully completed the standard modified radical mastectomy,and the time of lymph node examination in the observation group and the control group was(11.15±0.93)minutes and(16.0±1.08)minutes,respectively.Check out the total number of lymph nodes is respectively 703 and 265,the per capita number of lymph nodes detected respectively(35.15±3.77),and(13.25±2.69).in diameter<5 mm,the total number of lymph nodes,respectively for 300 to 74,the diameter of<5 mm per capita number of lymph nodes(15.0±2.81),respectively,(3.70±1.26),and lymph node<12 cases patients with 0 cases and 7 cases respectively,two groups of patients with the above comparison,differences were statistically significant(t=19.91,20.49,17.63,P<0.05).The total number of positive lymph nodes in the observation group and the control group was 130 and 34 respectively,and the positive lymph nodes rate was 18.49%and 12.83%,respectively.The difference in positive lymph nodes rate between the two groups was statistically significant(x2=4.38,p<0.05).Two groups of patients with operation time,respectively(92.45±5.29)minutes(121.45±6.68)minutes,and intraoperative blood loss,respectively(86.05±4.67)for ml and(112.05±5.81)ml,postoperative hospitalization days,respectively(6.20±0.77)and(10.80±1.01)days,total guide flow respectively(261±11.07)ml and(376.75±14.89)ml,pull out the tube days respectively(5.80±0.77)and(11.30±0.73)days.The differences were statistically significant(t=-13.47,-16.99,-16.16,-34.97,-24.59,P<0.05).(2)follow-up.All the 40 patients were followed up for 12-18 months and the median follow-up was 16 months.Follow-up period,the observation group and control group had no tumor recurrence and metastasis,observation group with upper limb lymphedema in 7 cases,control group in 12 cases with upper limb lymphedema,observation group with upper lateral skin pain paralysis and the shoulder movement disorder,respectively 7 cases,6 cases in the control group there are upper lateral skin pain paralysis and the shoulder movement disorder for 12 cases and 11 cases respectively,these indicators are two groups of patients,there was no statistically significant difference(x2=2.51,2.51,2.56,p>0.05).Conclusions:carbon nanocomposite in breast cancer axillary lymph node dissection can improve the efficiency of lymph node separation and the detection rate of axillary lymph node and the positive rate of axillary lymph node,making the postoperative pathological staging more accurate.lt can shorten operation time,reduce intraoperative blood loss,reduce total postoperative drainage flow,remove drainage tube in advance and shorten the length of hospital stay.However,the application of nano-carbon tracer technique in breast cancer axillary lymph node dissection can not reduce the incidence of lymphedema,skin palsy and shoulder movement disorder of the affected side. |
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