非加压包扎双管引流法在乳癌根治术中的应用

Non pressed dressing and double tubes drainage in radical mastectomy for breast cancer

目的 探讨减少乳癌手术后皮下积液等并发症的方法。方法 对 1997年 4月～1999年 6月间 72例乳癌根治术后病人的临床资料进行回顾性分析。结果 42例病人采用双管引流不加压包扎 (双管组 ) ,30例病人采用传统的加压包扎单管引流 (单管组 )。观察发现 :手术后前 3d的引流量双管组 (30 2 .9± 12 9.9)ml明显大于单管组 (15 3 .8± 91.0 )ml(P<0 .0 1) ,手术后 4～ 6d的引流量双管组 (73 .4± 89.4)ml与单管组 (6 2 .1± 39.2 )ml无显著性差异 (P >0 .0 5 )。手术后皮下积液的发生率双管组 (2 / 42 ,4.8% ) ,明显少于单管组 (9/30 ,30 0 % ) (P <0 .0 1)。单管组有 3例病人手术后出现皮瓣坏死或切口延迟愈合 ,而双管组未发生这种情况。结论 我们认为在乳癌手术后的创面处理中 ,非加压包扎双管引流要比加压包扎单管引流更为充分 ,并且应用双管引流可明显降低皮下积液等并发症的发生率。

Objective To investigate the method of decreasing the complication of subcutaneous liquid collection after radical breast cancer(BC) operation. Methods The clinical data of 72 patients treated with BC after radical mastectomy from April,1997 to June,1999 were analyzed retrospectively. Results 42 patients by using non-pressed dressing and double suction drainage(DSD),30 patients were treated by pressed dressing and single suction drainage (SSD). The results showed that the volume of drainage in the first 3 days after operation between DSD group (302.9 ±129.9)ml and SSD group (153.8±91.0)ml was significant different (P<0.01). But the volume of drainage was of no significant difference between the two groups (73.4±89.4 ml vs 62.1 ±39.2 ml) in the 4～6 days after operation (P>0.05). The skin flap necrosis occurred in 3 cases in SSD group, but none in DSD group (P<0.01). Conclusions The results suggest that using double suction drainage could get more complete drainage than SSD did, and meanwhile DSD can decrease the postoperative complication rate.