乳腺癌术后皮下积液和皮瓣坏死的防治

Prevention and Treatment of Subcutaneous Hydrops and Skin Flap Necrosis after Breast Cancer Surgery

目的探讨乳腺癌术后皮下积液和皮瓣坏死的产生原因、处理及预防对策。方法以2013年10月至2015年9月收治的178例乳腺癌手术患者为研究对象，回顾性分析发生皮瓣坏死和皮下积液的原因，提出预防和处理对策。结果178例患者中有29例患者术后出现皮下积液，占16．3％（29／178），6例术后发生皮瓣坏死，占3．4％（6／178），经过穿刺、引流等治疗处理后均治愈。结论乳腺癌手术前合理的切口设计，术中细心操作，改良缝合方法，术后弹性胸带加压包扎、保持皮下负压引流管通畅等，可有效预防和减少皮下积液、皮瓣坏死。．

Objective To investigate the causes, preventions and treatments of subcutaneous hydrops and skin flap necrosis after breast cancer surgery. Methods A total of 178 patients with breast cancer treated with curative surgery from Oct. 2013 to Sep. 2015 were enrolled in this study. The causes of subcutaneous hydrops and skin flap necrosis were investigated and detailed treatments were analyzed. Results Among the 178 patients, subcutaneous hydrops occurred in 29 cases（ 16.3% ） and skin flap necrosis occurred in 6 cases（3.4% ） which were all successfully treated by puncture and drainage. Conclusion Rational incision design before operation, serious operation, improved suture method, proper bandage pressure and adequate subcutaneous suction drainage can prevent and reduce subcutaneous hydrops and skin flap necrosis.