超声刀在乳腺癌全乳切除和腋窝淋巴结解剖术中的应用

Application of ultrasonically activated scalpel in total mastectomy and axillary lymph node dissection for breast cancer

目的研究超声刀在乳腺癌全乳切除和腋窝淋巴结解剖术中的应用效果。方法回顾性分析177例乳腺癌全乳切除和腋窝淋巴结解剖术患者的临床资料，其中91例联合使用超声刀与电刀，86例单用电刀，比较两组手术时间、术中出血量、术后引流情况、引流管放置时间、以及并发症的发生率。结果超声刀／电刀联合组手术时间、术中出血量、术后24h引流量、引流管放置时间均明显优于单用电刀组（P〈0．05）；而术后皮下积液的发生率两组差异无统计学意义（P〉0．05）。结论在乳腺癌全乳切除和腋窝淋巴结解剖术中超声刀／电刀联合应用比单用电刀有明显的优势。

Objective To study the therapeutic effectiveness of ultrasonically activated scalpel （UAS）in the total mastectomy and axillary lymph node dissection for breast cancer. Methods A retro- spective analysis was performed on 177 patients who received total mastectomy and axillary lymph node dissection for mastocarcinoma. The 177 patients were divided into two groups ：91 cases were subjected to UAS combined with high frequency electrotome （HFE）, and 86 cases to HFE only. Operative time, blood loss, postoperative 24 h drainage volume, indwelling duration of drainage tube, and postoperative complica- tions in the two groups were compared. Results The operative time, blood loss, postoperative 24 h drain- age volume,indwelling duration of drainage tube in group of UAS combined with HFE were dramatically decreased as compared with HFE group（P 〈 0.05 ）. However there was no significant difference in postop- erative incidence of subcutaneous seroma between the two groups （P 〉 0.05）. Conclusion The therapeu- tic effectiveness of UAS combined with HFE is better than that of HFE alone in total mastectomy and axillary lymph node dissection for breast cancer.