简介:目的探讨临床Ⅰ、Ⅱ期乳腺癌腔镜腋窝淋巴结清扫术的可行性。方法本院2006年1月至2008年1月对临床Ⅰ、Ⅱ期乳腺癌患者行腔镜下腋窝淋巴结清扫术55例,同时选取传统腋窝淋巴结清扫术63例,对两组手术时间、出血量、淋巴结清扫数量、腋下引流液量及预后进行比较。定量资料的分析采用t检验;定性资料的比较用x^2检验。结果腔镜手术组手术时间平均121.0min,术中出血51.0ml,平均每例清扫淋巴结数量17.3枚,术后总引流量平均208.0ml,随访1~3年术后复发转移者2例;对照组手术时间平均70.0min,术中出血平均80.0ml,平均每例清扫淋巴结19.5枚,术后总引流量平均350.0ml,术后复发转移者2例。腔镜手术组手术时间较传统手术长,但术中出血及术后引流液明显低于传统手术(P〈0.05)。两组间近期复发转移率比较,差异无统计学意义(x^2=0.02,P=0.89)。结论腔镜手术可以达到传统手术的治疗效果。
简介:1临床资料病例1:患者,23岁,G3P0,38+6周孕临产,因"阴道见红伴下腹痛1小时"于2007年8月12日入院。孕期建卡及常规产前检查无异常。入院产科检查:宫高34cm,腹围92cm,胎位枕左前位(leftoccipitoanterior,LOA),胎心音142次/min,抬头入盆,骨盆外测量正常。肛门检查:宫颈管消失,宫口开大1+cm,先露-1。内骨盆无异常。B超:胎儿双顶间径为9.0cm,股骨长度为7.2cm,胎盘位于子宫后壁,成熟度II级;羊水深度为4.2cm,羊水指数为13.2cm。可行阴道分娩。于当日14:20开始出现规律宫缩,15:50自然破膜,羊水清亮,
简介:ObjectiveThisstudywasinitiallydesignedtoevaluatetheeffectofcelecoxibontheregimenof5-fluorouracil,epirubicin,andcyclophosphamide(FEC)combination,followedbydocetaxel(T)inneoadjuvantsetting.AnunplannedpreliminaryreviewonsafetywasconductedafterahaltofthestudyduetotheconcernedpotentialcardiovascularriskofusingCOX-2inhibitors.MethodsWestudied23consecutivecasesofoperablebreastcancerhavingreceivedfourcyclesofFEC(500mg/m2,100mg/m2,500mg/m2)followedbyfourcyclesofT(100mg/m2)withconcurrentcelecoxib(400mgtwicedaily)(groupA)orsamechemotherapyregimenbutwithoutconcurrentcelecoxib(groupB).Thesecombinedchemotherapieswereadministeredevery3weeks.TheChi-squaretestorFisher'sexacttestwereusedtoassessthedifferenceinincidenceoflimitinghematologicaltoxicitesbetweengroups.Results23patients(groupA:n=12;groupB,n=11)receivedatotalof183outof184plannedtreatmentcycles;one(4%,1/23)ofthemomittedthefourthcycleofFECowingtorepeatedincidencesoffebrileneutropenia.Receiveddoseintensity(RDI)forFECingroupA(90%±11%)washigherthanthatingroupB(80%±8%)whileRDIforTwassimilarbetweengroupA(93%±8%)andgroupB(96%±9%).Ofthefirst91treatmentcyclesofFEC,limitinghematologicaltoxicity,severeneutropeniaincludingfebrileneutropenia,wassignificantlydifferentbetweengroupAandB[(10.4%,5/48)vs.(32.6%,14/43),P=0.009].Othertoxicitiescommonlyobservedinchemotherapyreceivingpatientsweremanageable.ConclusionsNeoadjuvantuseofFECfollowedbyTwithconcurrentcelecoxibappearedtobesafefortreatmentofoperableinvasivebreastcancer.Theobservedlowerincidenceofchemotherapy-inducedneutropeniaispossiblycontributedbytheadministrationofCOX-inhibitor.WebelievethatfurtherinvestigationmightprovidemoreevidenceontheuseofCOX-2inhibitorsinbreastcancer.