乳腺癌术后皮下积液的多因素分析及治疗体会

Multivariate analysis of affecting accumulative liquid of subcutaneous after operation on breast cancer and treatment

目的探讨乳腺癌手术后皮下积液的相关危险因素及术后治疗体会。方法回顾性分析新疆医科大学附属肿瘤医院2008年7月—2009年7月收治的340例女性初发乳腺癌患者的临床资料,术后有42例发生皮下积液,采用单因素和多因素分析乳腺癌术后积液的相关危险因素。结果 340例乳腺癌病例术后皮下积液的总发生率为12.4%。单因素分析提示:术后TNM分期、淋巴结清扫数目及范围、术后放化疗、体重指数、有无合并症是影响术后积液的重要因素。多因素分析示影响术后积液的重要因素依次为:淋巴结清扫数目、淋巴结清扫范围、术后放化疗、体重指数、有无合并症。结论对于病期较晚、淋巴结清扫范围广、体重指数高及合并有糖尿病患者要采取积极措施防止术后皮下积液发生,术后选择合适的治疗方案。

Objective To study the risk factors for accumulative liquid of subcutaneous after operation on breast cancer and treatment accumulative liquid of subcutaneous.Methods Between July 2008 to July 2009,among 340 patients,only 42 patients developed subcutaneous hydrops.The history records of 42 patients were analyzed with univariate analysis and multivariate analysis.Results The rate of accumulative liquid of subcutaneous was 12.4%（42/340）.With univariate analysis,the range of resection,tumour node metastases（TNM） clinical stage,chemotherapy and radiation therapy,number of invaded axillary lymph nodes,BMI were significant factors associated with accumulative liquid of subcutaneous after operation on breast cancer.Multivariate analysis by Logistic proportional hazards regression model showed that number of metastatic axillary lymph nodes,chemotherapy and radiation therapy,patients had diabetic mellitus and BMI were independent factors associated with accumulative liquid of subcutaneous after operation on breast cancer.Conclusion The study indicates that number of metastatic axillary lymph nodes,chemotherapy and radiation therapy,patients had diabetic mellitus and BMI are important factors associated with the possibility of accumulative liquid of subcutaneous after operation on breast cancer.after operation,it must be taken effective measures to prevent subcutaneous hydrops.