内窥镜辅助腋窝入路隆乳术后不同负压水平对引流量影响的随机对照临床研究

Influence of different amounts of negative pressure on postoperative drainage volume in axillary endoscopic breast augmentation:a randomized controlled clinical trial

目的探讨内窥镜辅助下腋窝入路硅凝胶假体隆乳术后不同负压水平对引流量的影响。方法从2018年1月1日至2019年5月31日间于华中科技大学同济医学院附属协和医院整形外科行内窥镜辅助下腋窝入路隆乳的患者中选择研究对象,将符合入组标准的患者按随机数字表法分为高负压、低负压2组。高负压组应用600 ml负压瓶(-90 kPa)行术后引流,低负压组应用200 ml负压球(-10~-16 kPa)行术后引流,记录2组患者术后每日引流量、引流管放置时间、引流液总量以及并发症情况。采用独立样本t检验或两独立样本秩和检验行组间比较。结果共56例女性患者符合入组标准,高负压组28例,年龄(28.2±4.1)岁,体质量指数为(19.2±1.4)kg/m 2,置入假体容积为(249.2±24.9)ml;低负压组28例,年龄(27.0±3.3)岁,体质量指数为(19.1±1.2)kg/m 2,置入假体容积为(257.5±23.8)ml。2组患者基线数据比较,差异无统计学意义(P>0.05)。2组日均引流量(除第3天)比较,差异均有统计学意义(P<0.05);高、低负压组引流管放置时间分别为(5.9±0.9)d和(4.8±1.1)d,单侧乳房引流液总量分别为(336.4±86.7)ml和(233.5±43.8)ml,2组间差异均有统计学意义(P<0.05)。术后随访12个月,2组患者均无血肿、血清肿、感染或包膜挛缩发生,其中高负压组有1例(3.6%)患者因右侧假体上移,行隆乳术后假体上移矫正。结论在内窥镜辅助腋窝入路隆乳术后,采用低负压引流(-10~-16 kPa)时较高负压(-90 kPa)术后引流液总量明显减少、置管时间明显缩短。

Objective To investigate the influences of different amounts of negative pressure on postoperative drainage volume for patients undergoing axillary endoscopic augmentation mammoplasty.Methods According to the random number table,patients who were admitted to the Department of Plastic Surgery,Union Hospital,Tongji Medical College,Huazhong University of Science and Technology for augmentation mammoplasty between January 1st,2018 and May 31st,2019 were randomly grouped into high negative pressure group and low negative pressure group respectively.In the high negative pressure group,-90 kPa negative pressure was applied through a 600 ml negative pressure drainage bottle.In the low negative pressure group,-10 to-16 kPa negative pressure was applied through a 200 ml negative pressure drainage ball.Total drainage volume,drainage volume per day,drainage placement time,incidence and types of complications were recorded.Independent sample t-test or the rank-sum test for two independent samples was applied for comparison between groups.Results A total of 56 patients who met the inclusion criteria were divided into high negative pressure group(age 28.2±4.1 years)and low negative pressure group(age 27.0±3.3 years).Patients’BMI was(19.2±1.4)kg/m2 in the high negative pressure group and(19.1±1.2)kg/m2 in the low negative pressure group.Implant volume was(249.2±24.9)ml in the high negative pressure group and(257.5±23.8)ml in the low negative pressure group.There was no significant difference in baseline data between 2 groups(P>0.05).There were significant differences in the daily drainage volume per breast(except for the third day),total drainage volume per breast and the duration of drainage placement between the two groups.The duration of drainage placement was 5.9±0.9 days in the high negative pressure group and 4.8±1.1 days in the low negative pressure group.Total drainage volume per breast was(336.4±86.7)ml in the high negative pressure group and(233.5±43.8)ml in the low negative pressure group.Patients were followed up for 12 months.No hematoma,seroma,inflammation or capsular contracture occurred in either group.One patient(3.6%)suffered breast implant displacement in the high negative pressure group and had revisional surgery.Conclusions Lower negative pressure(-10 to-16 kPa)was associated with less drainage volume and shorter drainage placement time compared to higher negative pressure(-90 kPa)in patients undergoing axillary endoscopic augmentation mammoplasty.