乳腺癌改良根治术后皮下积液产生的高危因素及预防措施

Risk Factors and Preventive Measures of Seroma for Breast Cancer Patients Treated with Modified Radical Mastectomy

目的探讨乳腺癌改良根治术后皮下积液产生的高危因素及预防措施。方法回顾性分析395例乳腺癌改良根治术患者的临床资料,分为传统手术组237例及改进手术组158例。统计分析传统手术组中患者临床因素与皮下积液的关系,确定术后积液的高危因素;对比2组患者术后积液发生率,分析改进手术方法在预防皮下积液中的作用。结果 2组积液发生率(41.77%vs 8.86%)差异具有统计学意义(P<0.01)。对传统手术组行统计分析发现,皮下积液发生率在腋窝淋巴结阳性者与腋窝淋巴结阴性者(48.85%vs 22.22%)、体重指数(body mass index,BMI)≥25与BMI<25者(53.85%vs 35.85%)、合并糖尿病与无病者(56.10%vs 38.78%)之间差异明显(P<0.05)。结论腋窝淋巴结阳性、BMI≥25及合并糖尿病为术后皮下积液产生的高危因素;改进手术方式可以明显减少积液的发生。

Objective To investigate the risk factors and prevention measures of seroma for breast cancer patients trea- ted with modified radical mastectomy. Methods Retrospective analysis the clinical data of 395 breast cancer patients treated with modified radical mastectomy,237 patients were divided into conventional surgery group and 158 cases were divided into improved surgical group. The clinical factors of conventional surgery group were analyzed to confirm the risk factors. The incidence of seroma in 2 groups were observed and compared to analyze the effect of improved surgery method. Results Compared to the 2 groups, the incidence of seroma（41.77% vs 8.86% ） was significantly different, with statistical difference （ P 〈 0. 01 ）. According to the statistical analysis of conventional surgery group, we found that the difference of the incidence of seroma had statistical significance （P 〈 0. 05 ） between patients axillary lymph node positive and axillary lymph node negative （48.85 % vs 22.22% ）, BMI ≥ 25 and BMI 〈 25 （53.85% vs 35.85% ） ,with and without diabetes mellitus（ 56.10% vs 38.78% ）. Conclusion The axillary lymph node positive, BMI ≥ 25, with diabetes mellitus are the risk factors of seroma,improve on the way of operation can obviously reduce the seroma.