乳腺癌手术并发症的预防和处理

Prevention and Treatment of Operative Complications of Breast Carcinoma

目的 探讨乳腺癌手术并发症的预防和处理。方法 用外科手术不同方式治疗乳腺癌 2 4 5例临床资料 ,对外科手术并发症的产生原因进行回顾性分析 ,提出了预防和处理方法。结果 腋静脉损伤 2例 ,气胸1例 ,头静脉损伤 1例 ,皮下积液 19例 ,皮瓣坏死 18例 ,患侧上肢水肿 9例 ,上肢活动受限 16例。并发症发生率 2 2 .4 %。结论 仔细解剖可避免术中并发症 ,采用负压引流法 ,皮瓣的厚度和张力适宜 ,可有效防止皮下积液及皮瓣坏死 ,切口设计合理 ,锐性解剖腋窝 ,避免头静脉损伤 ,可有效减轻上肢水肿 ,术后功能锻炼 。

Objective To explore the prevention and treatment of operative complications of breast carcinoma. Methods The clinical data of 245 patients with breast carcinoma were summarized, and a retrospective analysis on the causes of operative complications was made.The methods of prevention and treatment of operative complications were put forward. Results Axillary vein was injuried in two cases,head vein was injuried in one case, one case complicated pneumotnorax,18 cases with skin necrosis, 19 cases with skin subcutaneous occumulated fluid, upper limb of 9 cases was edoma, lifting of upper limb of 16 case was arrested. The rate of the operative complications of breast carcinoma was 22.4%. Conclusion Anatomy attentively during operation is important to avoid complication. Choice of drainage of the minus pressure and right thick of skin is effective to prevent subcutaneous occumulated fluid.Skin neurosis choice of right stemotomy and sharp anatomy axillas can avoid injury of head vein, reduce obvious edema of upper limb. Practising after operation and not selecting the stemotomy toward axiuas is key to prevent arrested lifting of limb.