超声刀在乳腺癌腋淋巴结清扫中的临床应用

The application of ultrasonically activated scalpel in axiilary lymph node dissection of breast cancer

目的 比较用超声刀与电刀行乳腺癌腋淋巴结清扫术的临床效果。方法回顾性分析105例乳腺癌改良根治术手术资料，其中41例术中用超声刀手术，64例术中用电刀，比较两组特殊器械的应用，腋窝清扫时间、术中清扫腋窝出血量、术后引流量、引流液颜色、引流管留置时间、住院时间及术后并发症等。结果超声刀组与电刀组相比，腋窝清扫时间无显著差异（21．8±5．6minvs15．8±4．8min，P〉0．05），但住院时间（10．4±4．9dvs．18．2±6．8d，P〈0．05）、术中清扫腋窝出血量（5．1±3．7mLvs34．9±15．3mL，P〈0．05）、术中副损伤（0％vs4．7％，P〈0．05）、术后引流量（265．4±52．2mLvs．512．6±104．4mLP〈0．05）、术后并发症（12．20％vs18．75％，P〈0．05）在超声刀组明显少于电刀组，术后引流液超声刀组颜色变化快（1．8±0．5dVS．2．6±0．7d，P〈0．05）。结论乳腺癌改良根治术应用超声刀效果好，能减轻患者术后痛苦，并发症少。

Objective To compare the therapeutic effect of Ultrasonically Activated Scalpel （UHS） with electrotome in axillary lymph node dissection（ ALND） of breast cancer. Methods A retrospective analysis was performed on 105 patients who received modified radical mastectomy. And 41 cases only subject to UHS ,64 cases only subject to electrotome. We observed the difference of operation time,blood loss of ALND, postoperative drai- ning volume, duration of axillary draining and length of stay and postoperative complications. Results There was no significant difference in operating time,blood loss and length of stay between the two groups. However,the incidence of postoperative complications such as flap necrosis and postoperative rehaemorrhagia in UHS group was dramatically decreased as compared with eleetrotome group. Conclusion The therapeutic effect of UHS is better than that of elect rotome in modified radical mastectomy.