乳腺癌根治/仿根治术后皮瓣下积液44例的处理

Breast cancer radical/imitation radical effusion under the flap handle a report of 44 cases

目的探讨乳腺癌根治术/仿根治术后皮瓣积液的处理方法,提高乳腺癌的近期疗效。方法回顾44例皮瓣下积液负压引流的再通畅,加压包扎和橡皮条的引流。结果 44例皮瓣积液中,除1例小动脉凝血痂脱落,行手术止血外,其余43例经负压引流再通畅16例,局部橡皮条引流21例,注射器抽吸和局部加压6例,消除局部皮瓣积气积液,未明显影响皮瓣和组织创面的愈合,无皮瓣坏死。皮瓣积液临床病程1.0～6.5d,平均(3.5±3.0)d。拔管时间标准:负压引流液<10mL/24h,拔管时间4～15d,平均(7.5±4.0)d。皮瓣愈合时间12～21d,平均(15.5±4.0)d。皮瓣在术后3周内一期临床愈合。结论乳腺癌根治术/仿根治术后皮瓣下积液的及时有效处置,对于预防乳腺皮瓣坏死,乳腺癌根治术/仿根治术后的近期疗效有积极的临床意义。

Objective To investigate the radical mastectomy/the flap effusion imitation radical approach,improve recent efficacy of of breast cancer.Methods 44 cases of subepithelial fluid suction drainage re-open,pressure bandage and rubber drainage.Results Flap effusion in 44 cases,except one cases of arterial clotting scab off,underwent surgery to stop bleeding,and the remaining 43 cases of negative pressure drainage and then usually 16 cases,local rubber drainage in 21 cases,syringe pump and 6 cases of partial pressure,and the elimination of local flap product gas effusion did not significantly affect the flap and tissue wound healing,flap necrosis.Flap effusion clinical course of 1.0 ～ 6.5 d,the mean duration of（3.5 ± 3.0）d.Time to extubation criteria：negative pressure drainage liquid 10 mL/24 h,extubation time：4 ～ 15 d,the average time（7.5±4.0）d.Flap healing time of 12 ～ 21 d,an average of（15.5±4.0）d.Flap after three weeks of a clinical healing.Conclusion Radical Mastectomy/imitation of timely and effective disposal of the effusion under the skin flap will die for the prevention of breast flap,radical mastectomy/imitation radical short-term effect of postoperative positive clinical significance.