超声刀联合腋下皮瓣多点缝合法在减少乳腺癌术后腋窝积液中的作用

Study on the application of ultrasonic scalpel combined with armpit flap multi- suture in reducing armpit effusion

目的探讨超声刀联合腋下皮瓣多点缝合法在减少乳腺癌术后腋窝积液中的作用。方法选择女性乳腺癌患者共126例。依据手术方法分为3组:A组采用超声刀联合腋下皮瓣多点缝合法(43例);B组采用腋窝处皮瓣多点缝合,但未使用超声刀(40例);C组术中未采用超声刀与皮瓣多点缝合技术(对照组,43例)。比较各组手术时间、术中出血量、术中主要结构损伤情况、引流管留置时间、术后引流量、淋巴结检出数、腋窝积液的发生情况等。结果三组在手术时间、淋巴结检出数无统计学差异。A组术中出血量、引流管留置时间和术后引流量显著低于B组和C组。A组腋窝积液发生率显著低于B组和C组。结论乳腺癌改良根治术中运用超声刀与腋窝处的皮瓣多点缝合法能显著减术后腋窝积液的发生。

Objective To explore the effect of application of ultrasonic scalpel combined with armpit flap multi- suture in reducing the effusion of armpit. Methods 126 female patients with breast cancer were collected. They were divided into three groups based on their surgical procedures： patients in group A were applied with armpit flap multi- suture and ultrasonic scalpel（ n = 43）,patients in group B were used armpit flap multi- point suture without using ultrasonic scalpel（ 40 cases）,patients in group C were applied with multi- point suture technique without intraoperative ultrasonic scalpel（ control group,43 cases）. Operating time,amount of blood loss,intraoperative major structural damage,the retention time of drainage tube,postoperative drainage,number of lymph nodes identified,the occurrence of armpit effusion and so on were compared. Results In these three groups,no significant difference had been found in operating time and the number of lymph nodes detected. The amount of blood loss,retention time of drainage tube and postoperative drainage in patients of group A were significantly lower than those in patients of group B and group C. The occurrence of armpit effusion in patients of group A was significantly lower than that of patients in group B and group C. Conclusion The appication of ultrasonic scalpel combined with multi- suture of armpit flap in modified radical mastectomy can significantly reduce the incidence of postoperative axillary effusion.