乳腺癌术后皮下积液的原因探讨及防治策略

Cause and Treatment Strategy of Patients with Accumulative Liquid of Subcutaneous after Modified Radical Mastectomy of Breast Cancer

目的探讨乳腺癌改良根治术后皮下积液的产生原因和防治方法。方法回顾性分析了芜湖市第二人民医院2006—2009年158例乳腺癌患者的临床资料，详细分析发生术后皮下积液的原因和防治经验。结果本组158病例中，25例出现皮下积液，发生率为15．8％，皮下积液经局部处理后均在15d内痊愈。其中15例经抽吸合并加压包扎。7例经重新置管，3例经刮勺搔刮积液腔壁后治愈。结论手术前合理地设计切口皮瓣和选择合适的术式：术中合理应用电刀，细心、认真地操作，正确处理淋巴管瘘；保留厚薄适度的皮瓣；术后确保负压引流通畅及适当的胸带加压包扎等综合防治措施可以明显降低皮下积液的发生率，使患者顺利进入下一步综合治疗并提高了患者的术后生活质量。

Objective To explore the eause and treatment methods of accumulative liquid of subcutaneous after modified radical mastectomy of breast cancer. Methods A retrospective analysis of prevention and treatment in 158 cases with aeeumulative liq- uid of subeutaneous after modified radical masteetomy of breast cancer from 2006 to 2009 in our hospital was performed. Results Among 158 patients,25 developped aecumulative liquid of subcutaneous. The incidence was 15.8%. After the treat- ment, the majority of accumulative liquid of subcutaneous patients were cured within 15 days. There were 15 patients healed with drainage and compression bandage,7 patients healed with re-drainage and 3 patients healed with scraping spoon. Conclusion The eomprehensive preventions and treatment measures whieh eonelude proper incision design, right mode of operation, the careful use of eleetmtome, ligating the lymphatic vessels, keeping the proper thickness flap, ensuring the continuous vacuum-suction drainage and effeetive compression wrapping could reduee the incidence of the aeeumulative liquid of subeutaneous, make patients accept the next comprehensive treatment smoothly and enhance life quality after the operation.