不同手术方式下乳腺癌皮下积液发生率对比

程少华，王雷，侯栋，秦双，薛会朝 *

新乡医学院，河南 新乡，453100

浏览次数：135次 下载次数：334次

摘要：

目的 探究不同手术方法对乳腺癌术后皮下积液发生率的影响。方法 将 2016年 2月至 2017年 11月在新乡医学院第一附属医院普外科行乳腺癌手术的 188例患者按照手术方式分为改良组（乳腺癌改良根治术，n=119）、保乳组（乳腺癌保乳手术，n=48）和重建组（乳腺癌术后即刻重建，n=21），比较三组皮下积液、皮瓣坏死、皮瓣感染发生情况。结果 改良组和保乳组皮下积液发生率及并发症总发生率有明显差异（P＜0.05）；改良组和重建组皮下积液发生率及并发症总发生率差异显著（P＜0.05）；保乳组和重建组皮下积液、皮瓣坏死、皮瓣感染发生率及并发症总发生率比较，无显著差异（P＞0.05）。结论 乳腺癌保乳手术及乳腺癌术后即刻重建可以降低皮下积液的发生率，在不影响患者生存率的情况下值得推广。

关键词：乳腺癌；手术方式；皮下积液

中图分类号：R737.9文献标志码：A文章编号： 2096-1413(2018)09-0009-02

Com parison oftheincidenceofsubcutaneouseffusion ofbreastcancerunder
differentsurgicalm ethods

CHENG Shao-hua,WANG Lei,HOU Dong,QIN Shuang,XUE Hui-chao *
(XinxiangMedicalUniversity,Xinxiang453100,China)




ABSTRACT: Objective To explore the effects of differents urgical methods on seroma formation in patients with breast cancer. Methods A total of 188 patients with breast cancer surgery in general department of the First Affiliated Hoapital of Xinxiang Medical University from February from 2016 to November 2017 were divided into modified group (modified radical mastectomy, n=119),breast-conserving group (breastconserving surgery,n=48) and reconstruction group (breast reconstruction immediately after surgery, n=21)according to surgery methods. The incidence of subcutaneous fluid,flap necrosis,skin flap infection among the three groups were compared.Results The incidence rate of subcutaneouse ffusion and the total incidence rate of complications between the modified group and the breast-conserving group were significantly different (P<0.05). The incidence srate of subcutaneou seffusion and the total incidence rate of complications between the modified group and the reconstructive group were significantly different (P<0.05).There were no significantdifferencesin the incidence of subcutaneous fluid,skin flap necrosis,skin flap infection and total incidence of complications between the breast-conserving group and reconstructive group (P>0.05). Conclusion Breast conserving surgery and breast reconstruction immediately after surgery both can reduce the incidence of seromaformation,which are worthy of promotion without affecting the rate of survival.
KEYWORDS: breast cancer;surgical methods; seroma formation

参考文献：
[1]KONG D,LIU Y,LIZ,etal.OK-432 (sapylin)reducesseromaformation afteraxillarylymph adenectomyin breastcancer[J].JInvest Surg,2017,30(1):1-5.
[2] VAN BASTELAAR J,THEUNISSEN LLB,SNOEIJS MGJ,etal.Flapfixation using tissue glue orsuturesaftermastectomy mightalso reduce risk of developing lymphedema in breastcancer[J].Clinireastancer,2017,17(4):316-321.
[3]YENIDOGAN E,AKGUL GG,GULCELIK MA,etal.Effectof-glucan on drain fluid and amountofdrainage following modified radicalmastectomy[J].Advher,2014,31(1):130-139.
[4] 尹健.乳腺癌术后乳房重建的策略 [J]. 中华临床医师杂志 : 电子版 ,2015,9(6):16-19.
[5] 连小艳,陈智明 . 乳腺癌改良根治术后并发症原因与预防 [J]. 临床医学研究与实践 ,2017,2(3):68-69.
[6] 黄临凌.保乳手术与改良根治术治疗早期乳腺癌的远期疗效对比[J]. 实用临床医药杂志 ,2017,21(3):130-132.
[7]ROLPH R,MEHTA S,FARHADIJ.Breastreconstruction:optionsoptionspost-mastectomy[J].BrJHosp Med,2016,77(6):334-342
[8]HUANG H,KONG D,LIU Y,etal.Sapylin promoteswound healing inmouse skin flaps[J].Am JTranslRes,2017,9(6):3017-3026.
[9] 颜宁,吴楚成 , 陈叔如 , 等 . 乳腺癌保留乳头乳晕的乳腺切除术联合假体即刻重建术的应用 [J]. 中国伤残医学 ,2015,33(2):101-102.
[10] 方明.乳腺癌保乳手术与改良根治术的疗效对比分析 [J]. 实用妇科内分泌杂志 ,2016,3(17):20-22.
[11] 顾筱旻.早期乳腺癌保乳手术与改良根治术的疗效对比 [J]. 中国普通外科杂志 ,2013,22(11):1511-1513.
[12] 黄湛,李敏,杨传盛,等.早期乳腺癌保留乳头乳晕复合体改良根治并一期乳房重建 [J]. 中国肿瘤外科 ,2013,5(2):106-108.
[13]MUNHOZ AM,MONTAG E,FILASSIJR,etal.Immediate nippleareola-sparing mastectomy reconstruction: an update on oncologicaland reconstruction techniques[J].W orld JClin Oncol,2014,5(3):478-494.
[14] 孙建伟,刘春生,赖明华,等.保留 NAC 的改良根治术并一期乳房重建术治疗早期乳腺癌的临床效果 [J]. 中国普通外科杂志 ,2015,4(11):1530-1535.