乳腺癌改良根治术后皮下积液的预防措施

Clinical prevention and treatment of subeutaneous fluid accumulation after modified radical mastectomy

目的 探讨乳腺癌术后皮下积液的防治方法。方法 回顾北京友谊医院普外科2002年1月～2004年12月收治的女性乳腺癌患者312例。比较皮下引流管接持续高负压吸引组（A组）与持续低负压引流组（B组），乳腺癌改良根治术后皮下积液的发生率。结果 A组160例患者拔管前合计引流量220～350ml，平均270ml。35例发生皮下积液，积液发生率为21．8％。同时伴皮瓣坏死5例。B组152例患者拔管前合计引流量160～250ml，平均180ml。17例发生皮下积液，积液发生率为11．2％。皮瓣坏死3例。B组与A组比较皮下积液发生率有显著性差异（P=0．011）。结论 乳腺癌改良根治术后引流管接持续低负压吸引有助于减少皮下积液的发生率。

Objective To investigate the prevention and treatment of subeutaneous fluid accumulation after modified radical mastectomy. Methods From January 2002 to December 2004, 312 patients with breast cancer undergoing modified radical mastectomy in Beijing Friendship Hospital were retrospectively analyzed. These patients were divided into two groups. Patients in group A and B received persistent high negative pressure drainage and low negative pressure drainage, respectively. The rate of subeutaneous fluid accumulation was compared between two groups. Results There were 160 cases in group A, and 35 cases with subeutaneous fluid accumulation, 5 cases with skin flap necrosis. The total drain output was from 220 to 350 ml, the mean total drain output was 270 ml. In group B, there were 152 cases in all, 17 cases of them with subeutaneous fluid accumulation, 3 cases with skin flap necrosis. The total drain output was from 160 to 250 ml, the mean total drain output was 180 ml. The total drain output in group B was significantly lower than that in group A（P =0. 011 ）. Conclusion Low negative pressure drainage is beneficial to reduction of the occurrence of subeutaneous fluid accumulation following modified radical mastectomy.