引流方式对乳腺癌改良根治术后皮下积液的影响

Influence of the Drainage Way to the Healing of the Subcutaneous Dropsy after the Modified Radical Mastectomy

目的探讨不同引流方式对乳腺癌改良根治术后皮下积液的影响。方法60例行乳腺癌改良根治术的患者均采用Stewart横切口,术后随机采用两种方式进行引流。A组采用单纯闭式持续负压引流+胸壁绷带加压包扎;B组采用双管闭式持续负压引流+胸壁绷带加压包扎。结果A组30例患者中,8例发生皮下积液,积液发生率26.7%;皮瓣坏死3例,坏死率10%。B组30例患者中,2例发生皮下积液,积液发生率6.7%;皮瓣坏死1例,坏死率3.3%。比较两组皮下积液发生率差别有显著意义(P<0.05),皮瓣坏死两组间差别无显著意义(P>0.05)。结论乳腺癌改良根治术后行双管闭式持续负压引流+胸壁绷带加压包扎,能明显减少皮下积液的发生率。

Objective To study the influence of different drainage ways to healing of the subcutaneous dropsy after modified radical mastectomy. Methods Sixty patients with breast carcinoma were performed modified radical operation with Stewart incision and randomly applied different drainage ways. In group A The compression bandaging on chest wall with the simple closed continous suction drainage was performed. In group B The compression bandaging on chest wall with double catheters of the closed continous suction drainage was performed. Results In group A There were eight patients occurred subcutaneous dropsy in thirty patients, the rote of fluid accumulation was 26.7 %. three cases occurred skin necrosis, the rate of necrosis was 10%. In group B There were two patients occurred subcutaneous dropsy in thirty patients, the rate of fluid accumulation was 6.7 %. one patient occurred skin necrosis, the rote of necrosis was 3.3 %. There was significant difference between two groups with comparison of subcutaneous dropsy, but the difference was undistinct in comparison of skin necrosis. Conclusion It is better to apply the compression bandaging on chest wall with double catheters of the closed continous suction drainage for the patients with breast carcinoma who performed modified radical operation, because this way may minimize the rate of subcutaneous dropsy.