防治乳腺癌术后皮下积液的方法改进:附204例报告
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管小青, Email: guan_dr@163.com

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Modified procedure for prevention of postoperative subcutaneous fluid collection after mastectomy: a report of 204 cases
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    摘要:

    目的:探讨乳腺癌患者术后皮下积液的防治措施。 方法: 回顾性分析2007年1月—2012年1月204例手术治疗的乳腺癌患者临床资料,其中106例(改良组)行常规腋窝淋巴结清扫,并于术中行淋巴管结扎、皮瓣与胸壁固定,术后双根引流管负压引流,98例(对照组)行传统手术方法,即在常规腋窝淋巴结清扫后置引流管1根负压引流。观察比较两组患者术后皮下积液发生情况。 结果:改良组与对照组发生皮下积液分别为9例(8.5%)和21例(21.4%),改良组术后积液发生率明显低于对照组(χ2=6.796,P<0.05)。对发生皮下积液者,经穿刺抽液,调整引流管位置或重新置管等相应措施,均获得治愈。 结论:改良手术方法可以降低乳腺癌患者术后皮下积液的发生,且未增加手术难度,值得临床应用。

    Abstract:

    Objective: To investigate the preventive measures for subcutaneous fluid collection in breast cancer patients after surgery. Methods: The clinical data of 204 breast cancer patients undergoing mastectomy from January 2007 to January 2012 were retrospectively analyzed. Of the patients, 106 cases (modified procedure group) underwent procedures that included the routine axillary lymph node dissection (ALND), lymph vessel ligation, fixation of the skin flaps to the chest wall, and placement of two drainage tubes for continuous vacuum suction; 98 cases (control group) received traditional procedures, namely the routine ALND, placement of one drainage tube and vacuum suction. The incidences of subcutaneous fluid collection of the two groups after surgery were observed and compared. Results: Nine case (8.5%) in modified procedure group and 21 cases (21.4%) in control group developed subcutaneous fluid collection, respectively; the incidence of subcutaneous fluid collection in modified procedure group was significantly lower than that of control group (χ2=6.796, P<0.05). Complete resolution of the subcutaneous fluid collections in all of the patients was achieved by appropriate managements such as puncture tapping, and drainage tube position adjustment or replacement. Conclusion: The modified surgical procedure can decrease the incidence of subcutaneous fluid collection in breast cancer patients after surgery and with no additional surgical difficulty, so its use is recommended.

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郑向欣|管小青|吴骥|顾书成|吴建强|陈焰|张旭旭.防治乳腺癌术后皮下积液的方法改进:附204例报告[J].中国普通外科杂志,2013,22(5):564-568.
DOI:10.7659/j. issn.1005-6947.2013.05.007

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  • 收稿日期:2012-12-14
  • 最后修改日期:2013-04-26
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  • 在线发布日期: 2013-05-15