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【摘要】目的:探讨乳腺癌术后皮下积液的防治方法。方法:回顾在院2004年～2007年12月收治女性乳腺癌患者146例,比较腋窝多孔单管负压引流加压包扎法(A组)与腋窝,胸壁双负压引流加压包扎法(B组),乳腺癌改良根治术后皮下积液的发生率。结果:A组皮下积液12例(16.4%),B组皮下积液3例(4.1%)②。两组皮下积液发生率有显著性差异。结纶:乳腺癌改良根治术后双负压引流加压包扎法有助于减少皮下积液的发生率。
【关键词】乳腺癌;皮下积液;预防控治
doi:10.3969/j.issn.1006-1959.2010.05.057文章编号:1006-1959(2010)-05-1089-02
【Abstract】Objective:Clinical prevention and treatment of subeutaneous fluid accumulation after modified radical mastectomy.Hu Xiao-Yan,Department of General Surgery,Zhu-Hai People"s Hospital of Guang Dong Province,Zhu Hai,519000,China.Methods:From January 2004 to December 2007.146 patients with breast cancer undergoing modified radical mastectony in my hospital were retrospectively analyzed.These patients were divided into two groups.Patients in group A and B received(persistebt armpit porous single tube negative pressure drainage and armpit,chest wall double tube negative pressure drainage respectively).The rate of subeutaneous fluid accumulation was compared between two groups.Results:There were 73 cases in group A and 12 cases with subeutaneous fluid accumulation.In group B,there were 73 cases in all,3 cases of them with subeutaneous fluid accumulation.The total drain output in group B was significantly lower than that in group A (P≤0.05).Conclusion:Double tube negative pressure drainageis beneficial to reduction of the occurrence of subeutaneous fluid accumulation following modified radical mastectomy.
【Key words】Breast cancer;Subeutaneous fluid accumulation;Prevention and treatment
乳腺癌是目前女性最常见的恶性肿瘤之一,近年来,其发病率呈逐年上升趋势。我国2000年乳腺癌新发病例为12.1万人;2005年为16.8万人,比2000年增加了38.5%,是女性癌症中增长最快的恶性肿瘤[1]。
乳腺癌改良根治术是治疗乳腺癌最直接,最有效的方法之一。由于手术范围大、创伤大、皮辨游离面广,术后容易发生皮下积液,报告其发生率为10～30%[2],国外文献报道发生率高达35%[3]。因此积极地预防乳腺癌改良根治术后皮下积液的发生是非常重要的术后治疗环节。
2004年1月～2007年12月,收集我院收治的女性乳腺癌患者146例,比较腋窝多孔单管负压引流加压包扎法(A组)与腋窝,胸壁双负压引流加压包扎法(B组)术后皮下积液的发生率。报告如下:
1.资料与方法
1.1 一般资料:我院2004年～2007年12月共收冶女性乳腺癌患者146例,平均年龄44(25～82)岁,所有病例均经术后病理证实诊断。根据国际TNM分期,A组I期15例,Ⅱ期48例,Ⅲ期10例,A组:术后病病理诊断:浸润性导管癌58例,髓性癌7例,其它类型8例;B组:术后病理诊断:浸润性导管癌61例,髓性癌6例,其它类型6例。B期I期10例,Ⅱ期56例,Ⅲ期7例。A组年平均年龄43(25～75)岁,B组平均年龄46(27～82)岁。
1.2 方法:两组均以手术刀分离皮瓣,分离腋窝时采取小块组织结扎,清扫完毕彻底冲洗创面,止血。A组采用腋窝多孔单管负压引流加压包扎的方法;B组采用腋窝、胸壁双负压引流加压包扎的方法。即用1根多孔橡皮引流管置于腋窝处,另一根多孔橡皮引流管置于胸骨旁,另一端由皮瓣最低点穿出,腋窝及胸壁加压包扎,压力均匀,以不影响患者呼吸为宜。
1.3 统计学方法:应用SPSS10统计软件比较两组皮下积液的发生率。
2.结果
A组皮下积液3例(4.1%),B组皮下积液12例(16.4%),两组皮下积液发生率有显著性差异(P
