乳腺癌改良根治术后腋窝填塞明胶海绵对减少腋窝积液的临床研究

Clinical study on reducing axillary effusion by gelatin sponge filling after modified radical mastectomy for breast cancer

目的了解导致乳腺癌改良根治术后腋窝积液的原因,探讨如何减少乳腺癌改良根治术后腋窝积液。方法将100例已经行乳腺癌改良根治术、BMI相近的患者随机分为两组。观察组50例,使用明胶海绵填塞腋窝＋腋窝负压引流＋术区加压包扎进行腋窝积液引流;对照组50例,使用腋窝负压引流＋术区加压包扎,观察并记录患者每日的腋窝积液引流量及拔管后的是否存在积液的情况,然后进行比较。结果观察组术后伤口1-3天的引流量、腋窝留置引流时间及拔管后腋窝积液的发生率显著低于对照组（P〈0.05）。观察组愈合所需要的时间显著比对照组短。结论导致乳腺癌改良根治术后腋窝淋巴积液的原因比较多,使用明胶海绵填塞腋窝腋静脉周围区域再加以负压引流和加压包扎可以有效减少腋窝积液的发生。

Objective To analyze the causes and treatment for axillary accumulative liquid of subcutaneous tissue following breast cancer modified radical mastectomy. Methods 100 patients who received modified radical mastectomy,with similar BMI,were randomized into study group（ 50 patients） and control group（ 50 patients）. The patients in the study group received gelatin sponge plugging around axillary vein,then drainage- tube was put and the wound were bandaged through pressure. The patients in the control group,only received drainage- tube putting at axillary and the wound were bandaged through pressure. The draining quantity of axillary was measured after the operation every day,as well as the occurrence of effusion after the remove of the drainage- tube. Results It is obviously that the draining volume,axillary indwelling drainage time and the occurrence rate of effusion after the remove of the drainage- tube of study group was less than that of the control group（ P〈 0. 05）. Conclusions The method of gelatin sponge filling has better effect on the prevention of the exudation after breast cancer modified radical mastectomy.