乳腺癌改良根治术后高负压持续吸引对预后的影响

Influence of high negative pressure drainage after modified radical mastectomy on patients prognosis

目的分析乳腺癌改良根治术后行高负压持续吸引对患者预后的影响。方法选取2013年3月至2013年9月浙江省肿瘤医院乳腺外科行乳腺癌改良根治术的62例患者为研究对象,将患者随机分为观察组和对照组,每组31例,观察组患者术后给予高负压持续吸引,对照组行常规低负压引流,比较两组患者的置管时间、创面愈合时间、住院时间以及术后感染、皮下积液以及皮瓣坏死等并发症的发生情况,同时对比两组患者术后恢复期的生活质量。结果观察组患者的创面愈合时间、置管时间、住院时间均显著低于对照组(t值分别为3.172、3.072、3.024,均P<0.05),观察组患者术后感染发生率、皮下积液发生率、皮瓣坏死发生率均显著低于对照组(x^2值分别为9.698、6.987、9.699,均P<0.05)。恢复期观察组患者疲劳、恶心与呕吐、疼痛、气促、失眠、食欲丧失等症状评分均显著低于对照组(t值分别为3.033、3.072、4.871、3.829、3.976、4.858,均P<0.05)。结论乳腺癌改良根治术后行高负压持续吸引能够减少创面愈合时间、置管时间以及住院时间,患者术后感染、皮下积液、皮瓣坏死等并发症少,且能够显著的提高患者恢复期的生存质量,值得临床推广应用。

Objective To analyze the influence of high negative pressure drainage after modified radical masteetomy on patients＇ prognosis. Methods Totally 62 patients undergoing modified radical mastectomy in Cancer Hospital of Zhejiang during the period of March 2013 to September 2013 were selected in the study, and they were randomly divided into observation group and control group with 31 cases in each group. The observation group was given high negative pressure drainage after modified radical masteetomy, while the control group underwent conventional low negative pressure drainage. The intubation time, healing time of wound, hospitalization length, postoperative infection, subcutaneous hydrops and skin flap necrosis were compared between two groups, and the quality of life during the recovery period was also compared. Results In the observation group patients＇ wound healing time, intubation time and hospitalization length were significantly shorter than those of the control group （ t value was 3. 172, 3. 072 and 3. 024, respectively, all P 〈 0.05 ）. The incidence of postoperative infection, subcutaneous hydrops and skin flap necrosis was significantly lower in the observation group than in the control group （χ^2 value was 9. 698, 6. 987 and 9. 699, respectively, all P 〈0.05）. During the recovery period, the scores of patient＇ s fatigue, nausea and vomiting, pain, shortness of breath, insomnia and loss of appetite were significantly lower in the observation group than in the control group （t value was 3. 033, 3. 072, 4. 871, 3. 829, 3. 976 and 4. 858, respectively, all P 〈0.05）. Conclusion High negative pressure drainage after modified radical mastectomy can reduce wound healing time, intubation time and hospitalization length, and the incidence of postoperative infection, subcutaneous hydrops and skin flap necrosis is less. It also can improve the life quality of patients during recovery period, so it is worthy of clinical application.