超声刀与普通电刀在乳腺癌腋窝淋巴结清扫术中的应用效果评价

Ultrasonic scalpel versus electrocautery in axillary dissection in breast cancer patients

目的：探讨在乳腺癌腋窝淋巴结清扫术中超声刀和普通电刀对乳腺癌术后并发症的影响。方法回顾性分析92例乳腺癌腋窝淋巴结清扫术患者的临床资料，患者随机选择手术方式，其中采用超声刀37例，普通电刀55例，比较两组患者淋巴结检出数、手术时间、术后24 h 引流量、血清肿发生率和腋窝引流管留置时间。结果超声刀组手术时间为（148．2±30．4）min、检出淋巴结17个，腋窝引流管留置时间为（16．0±5．3）d，普通电刀组分别为（143．5±40．8）min，16个和（16．7±4．4），两组比较差异无统计学意义（P ＞0．05），超声刀组术后24 h 引流量为（118．8±65．8）ml，血清肿发生率为8．1％；普通电刀组分别为（159．2±71．3）ml 和20％，两组比较差异有统计学意义（P ＜0．01）。结论在乳腺癌腋窝淋巴结清扫术中超声刀和普通电刀对腋窝淋巴结清扫效果比较无明显差异，但采用超声刀后患者术后并发症明显减少。

Objective To evaluate the effects of ultrasonic scalpel and traditional electrocautery on postoperative complications in axillary dissection for breast cancer treatment.Methods The clinical data of 92 breast cancer patients with axillary dissection were analyzed retrospectively.The surgical proce-dures were randomly chosen by patients,including 37 cases with ultrasonic scalpel and 55 cases with elec-trocautery.Both groups were compared in operation time,number of harvested lymph nodes,postoperative drainage in 24 h,seroma formation rate,and drain removal time.Results There were no significant differ-ences in operation time[（148.2 ±30.4）min vs（143.5 ±40.8）min],number of harvested lymph nodes （17 nodes vs 16 nodes）,and drain removal time[（16.0 ±5.3）d vs（16.7 ±4.4）d]between ultrasonic scalpel group and electrocautery group（P 〉0.05 ）.There were significant differences in postoperative drainage [（118.8 ±65.8）ml vs（159.2 ±71.3）ml]and seroma formation rate（8.1% vs 20%）between ultrasonic scalpel group and electrocautery group（P 〈0.01）.Conclusion For breast cancer,ultrasonic scalpel is similar to electrocautery in axillary dissection,but it can reduce postoperative complications.