摘要
目的:探讨为接受乳腺癌整形保乳术的乳腺癌患者采用分层引流法(组织瓣上+组织瓣下双管引流法)进行切口引流对其术后引流量、置管时间及并发症发生率的影响。方法:选取接受乳腺癌整形保乳术的乳腺癌患者97例,将其随机分为观察组和对照组。在为两组患者切除病灶、使用局部组织瓣修复填充缺损部位后,为观察组患者采用分层引流法进行切口引流,为对照组患者采用腺体瓣下单管引流法进行切口引流。然后比较两组患者术后3 d的引流量、术后置管的时间、术后切口感染、切口脂肪液化、皮瓣坏死及切口延迟愈合的发生情况。结果:1)在术后第1天、术后第2天和术后第3天,观察组患者的引流量均多于对照组患者,P<0.05。两组患者术后置管的时间相比,P>0.05。2)在术后,两组患者均未出现皮瓣坏死的情况。观察组患者术后切口脂肪液化、切口延迟愈合的发生率均低于对照组患者,P<0.05。两组患者术后切口感染的发生率相比,P>0.05。3)观察组患者中切除组织直径≥5cm患者术后置管的时间短于对照组患者中切除组织直径≥5cm的患者,P<0.05。4)在术后,两组患者中切除组织直径≥5 cm的患者均未出现皮瓣坏死的情况。观察组患者中切除组织直径≥5 cm患者术后切口延迟愈合的发生率低于对照组患者中切除组织直径≥5 cm的患者,P<0.05。两组患者中切除组织直径≥5 cm患者术后切口感染、切口脂肪液化的发生率相比,P>0.05。结论:与采用腺体瓣下单管引流法相比,为接受乳腺癌整形保乳术的乳腺癌患者采用分层引流法进行切口引流的效果较好,可有效地提高其术后引流量,降低其术后并发症的发生率,并可缩短其中切除组织直径较大患者术后置管的时间。
Objective:To investigate the effect of stratified incision drainage(upper flap+lower flap double tube drainage)on postoperative drainage volume,catheterization time and incidence of complications in breast cancer patients undergoing breast surgery and breast preservation.Methods:97 cases of breast cancer patients receiving plastic surgery for breast cancer were randomly divided into observation group and control group.After the lesions were removed and the defect was repaired and filled with local tissue flap,incision drainage was performed by stratified drainage in the observation group and single tube drainage by glandular flap in the control group.Then,the incidence of postoperative incision infection,incision fatliquefaction,flap necrosis and delayed incision healing were compared between the two groups 3 d after surgery.Results:1)On the 1st,2nd and 3rd postoperative days,the drainage volume in observation group was higher than that in control group,P<0.05.The postoperative catheterization time of the two groups was compared,P>0.05.2)After surgery,there was no flapnecrosis in both groups.The incidence of fat liquefaction and delayed incision healing in observation group was lower than that in control group,P<0.05.The incidence of postoperative incision infection was compared between the two groups,P>0.05.3)The postoperative catheterization time of patients in the observation group was shorter than that of patients in the control group with tissue diameter≥5cm,P<0.05.4)After surgery,no flap necrosis occurred in patients with resection diameter≥5 cm in both groups.The incidence of delayed incision healing in patients with resection diameter≥5 cm in the observation group was lower than that in the control group,P<0.05.The incidence of postoperative incision infection and incision fat liquefaction in patients with resection tissue diameter≥5 cm in the two groups was compared,P>0.05.Conclusion:compared with the glands disc placing tube drainage method is adopted,and for the breast cancer treated with breas
作者
李娜
邓雅媛
刘洋
查卓岑
候小晨
葛菲
孙文婧
胡曼婷
杨德春
陈文林
LI Na;DENG Yayuan;LIU Yang;CHA Zhuocen;HOU Xiaochen;GE Fei;SUN Wenjing;Chen Wenlin(Department of Mammary Surgery,The Third Affiliated Hospital of Kunming Medical University,Yunnan Cancer Hospital,Kunming 650118;Department of Breast Surgery,The First Affiliated Hospital of Kunming Medical University,Kunming 650032;Clinical College of Chongqing Medical University,Chongqing 400016)
基金
云南省卫生健康委员会医学学科带头人培养计划(D-2018002)
云南省科技计划昆医联合专项(202001AY070001-079)。
关键词
分层引流法
乳腺癌整形保乳术
引流量
并发症
置管
stratified drainage
Breast cancer plastic surgery
Lead flow
Complications
catheter
