便携式负压引流系统在乳腺癌改良根治术中的应用价值

Application value of portable negative pressure drainage system in modified radical mastectomy

目的评价便携式负压引流系统在乳腺癌改良根治术中的应用效果。方法回顾性分析2011年1月至2013年6月在本院行乳腺癌改良根治术的521例患者资料,其中接受便携式负压引流系统引流者279例(负压引流组),接受传统双管引流者242例(传统双管组)。比较两组患者的住院时间、置管时间、皮下积液和皮瓣坏死情况。计量资料分析采用秩和检验,计数资料比较采用χ2检验。结果负压引流组发生皮下积液8例(占2.87%,8/279),传统双管组发生皮下积液19例(占7.85%,19/242),两组间差异有统计学意义(χ2=6.551,P=0.010)。负压引流组发生轻度皮瓣坏死2例(占0.72%,2/279),传统双管组发生轻度皮瓣坏死6例(占2.48%,6/242),两组间差异无统计学意义(χ2=2.657,P=0.153)。传统双管组置管时间明显长于负压引流组,两组相比差异有统计学意义[M(QR):11(10)d比8(6)d,Z=-11.778,P=0.000]。负压引流组患者的住院时间明显短于传统双管组,两组相比差异也有统计学意义[M(QR):9(7)d比11(10)d,Z=-15.751,P=0.000]。结论应用便携式负压引流系统能够降低乳腺癌患者手术后并发症的发生率,增加床位周转率,增加患者的收治量,具有良好的使用价值,值得推广。

Objective To evaluate the effect of portable negative pressure drainage system after modified radical mastectomy. Methods A retrospective analysis of 521 cases with breast cancer who received modified radical mastectomy from Shanghai Changhai Hospital of Second Military Medical University from January 2011 to June 2013 were performed, including 279 patients treated with portable negative pressure drainage system, 242 patients treated with traditional two-tube drainage. The hospitalization time, drainage time, subcutaneous fluid and skin flap necrosis were recorded and compared between two groups. Measurement data were analyzed by rank sum test, count data by chi-square test. Results Subcutaneous liquid was observed in 8 cases of negative pressure drainage group （2. 87%, 8/279） and 19 cases of traditional two-tube group （7. 85%, 19/242）, and the difference was statistically significant between two groups（χ2=6. 551, P=0. 010）. Skin flap necrosis occurred in 2 cases of negative pressure drainage group （0. 72%, 2/279） and 6 cases of traditional two-tube group （2. 48%, 6/242）, which showed statistically significant difference （χ2=2. 657, P=0. 153）. The drainage time in traditional two-tube group was significantly longer than that in negative pressure drainage group [M（QR）：11（10） d vs 8（6） d,Z=-11. 778,P=0. 000]. The hospitalization time in traditional tow-tube group was significantly longer than that in negative pressure drainage group [M（QR）：11（10） d vs 9（7） d,Z=-15. 751,P=0. 000]. Conclusion The portable negative pressure drainage system can reduce the incidence of post-operative complications in breast cancer patients, increase the bed rotation rate and the enrollment of patients, and shows promising clinic value, worthy of wide application.