超声刀在乳腺癌Auchincloss改良根治术中应用的随机对照研究

Randomized Controlled Research on the Use of Harmonic Scalpel during Modified Radical Mastectomy for Patients with Breast Cancer

目的比较在乳腺癌Auchincloss改良根治术中使用超声刀及电刀手术的优、缺点。方法 2009年6月2010年7月将176例乳腺癌患者通过信封法随机分为超声刀组和电刀组,每组88例,分别比较两组患者手术时间、术中出血量、淋巴结检出数目、术后引流量、皮下积液及术后出血量的差异。结果手术时间:超声刀组为(145.72±50.76)min,电刀组为(171.27±66.68)min,两组差异有统计学意义(P=0.005);术中出血量:超声刀组为(71.56±31.34)mL,电刀组为(84.99±36.39)mL,两组差异有统计学意义(P=0.009);清扫出的淋巴结个数:超声刀组为(20.92±9.09)个,电刀组为(17.90±6.74)个,两组差异有统计学意义(P=0.013)。而在术后平均引流量和术后积液例数方面两组的差异无统计学意义(P>0.05)。两组均无术后出血的情况。结论在乳腺癌Auchincloss改良根治术中使用超声刀,较单独使用电刀能缩短手术时间,减少出血量,并增加淋巴结检出的数量。

Objective To compare the disadvantages and advantages between modified radical mastectomy with harmonic scalpel（HS） and conventional electro-scalpel（ES） for patients with breast cancer.Methods Between June 2009 and July 2010,176 patients with breast cancer were randomly divided into two groups including the HS group and the ES group.The operation time,intra-operative bleeding volume,the number of lymph nodes detected,postoperative drainage volume,subcutaneous hydrops,and postoperative hemorrhage volume between the two groups of patients were compared.Results There were significant differences between the HS and ES groups in terms of operation time [（145.72±50.76） minutes vs.（171.27±66.68） minutes,P=0.005],intra-operative bleeding volume [（71.56±31.34） mL vs.（84.99±36.39） mL,P=0.009],and number of lymph nodes detected（20.92±9.09 vs.17.90±6.74,P0.05）.The postoperative drainage volume and subcutaneous hydrops were not significantly different between the two groups（P0.05）.No postoperative hemorrhage occurred in both groups.Conclusion Compared with ES,the use of HS can reduce operation time and intra-operative bleeding volume,and increase the number of lymph nodes detected during modified radical mastectomy.