摘要
目的评价纳米碳携带化疗药进行乳腺癌术前淋巴化疗对术后近期局部并发症的影响。方法纳入无腋窝手术史，无胸壁、乳腺放射治疗史的125例可手术乳腺癌患者，术前非随机分人淋巴化疗组（lyrephangial chemotherapy，LC组）（73例）、单用纳米碳示踪组（carbon nanoparticles tracer，CNT组）（22例）、不示踪（nottracer，N．T组）（30例）。CNT组：取纳米碳混悬液1ml，于术前O．5～6．0h，用1ml空针在包块或活检残腔周围及乳晕皮内共选4—6点注射（保乳患者不选择乳晕皮内注射），注射后轻轻按摩注射部位3～5min。LC组：用化疗药表阿霉素5mg／0．5ml注入1ml纳米碳混悬液内，经20rain快速震荡后，于术前24—72h注入，注射取点和方法同CNT组。不示踪组：术前不使用纳米碳混悬液、亚甲兰等示踪剂。注射后观察记录：患者术前疼痛程度，局部皮肤坏死情况、术后皮瓣坏死、切口延迟愈合、切口感染、胸壁水肿、引流时间、引流量。结果3组无一例出现术前疼痛，LC组与CNT组术前、术后无一例出现皮瓣坏死，N-T组1例出现术后少许皮缘坏死。3组无一例出现切口延迟愈合和感染，无一例出现皮肤水肿。3组引流时间差异无统计学意义（（7．58±0．58）vs（7．09±0．83）VS（7．83±1．24），P=O．829），引流量差异无统计学意义（（397．78±41．80）VS（462．14±68．71）VS（418．72±71．18），P=0．327）。结论乳腺癌手术前淋巴化疗不会导致局部难以忍受的疼痛、皮瓣坏死、切口延迟愈合、切口感染、胸壁水肿等并发症发生率增加。不会导致术后引流量增多及引流时间延长。
Objective To evaluate the impact of the preoperative lymphatic chemotherapy by injecting nano carbon absorbing chemotherapeutic drugs （NCACDIon local and early stage complications for breast cancer patients after surgery. Methods 125 operable breast cancer patients without history of axillary dissection or radiotherapy for chest or breast were selected, and they were divided into three groups： 22 patients in CNT group（selecting 4-6 injection sites at residual cavity of biopsy and subcutaneous tissue of areola and injecting 1 ml nano carbon suspension （NC）at 0.5-6.0 h before surgery, then pressing these sites gently for 3-5 minutes）, 73 patients in LC group （injecting NCACD which mixed 5 mg/0.5 ml doxorubicin into 1 ml NC, then shaking quickly for about 20 minutes at 24-72 h before surgery, using the same injection site and method as in CNT group）, and 30 patients in N-T group （without using any tracer such as NC or methylene blue）. Preoperative pain, local skin necrosis, postoperative skin flap necrosis, delayed wound healing, postoperative infection and chest wall edema, drainage time and drainage volume were recorded. Results No preoperative pain, delayed wound healing, incision infection or skin swelling was observed in any of the three groups. No preoperative or postoperative skin flap necrosis occured in LC or CNT group while one patient had a little skin flap necrosis in N-T gToup. There was no significant difference in drainage time or drainage volume among the three groups. Conclusion Preoperative lymphatic chemotherapy for breast cancer patients will not lead to a higher incidence of local complications such as pain, flap necrosis, delayed wound healing or chest edema, thus it can be widely used in clinical treatment.
出处
《中华内分泌外科杂志》
CAS
2016年第1期54-57,共4页
Chinese Journal of Endocrine Surgery
关键词
乳腺肿瘤
淋巴化疗
纳米碳
活性炭
表阿霉素
Breast neoplasms
Lymphatic chemotherapy
Nano carbon
Carbon Nanoparticle
Ac- tivatid Carbon
