U型多点缝合固定皮瓣及三管负压引流预防乳腺癌改良根治术术后积液的疗效研究

Study on the Efficacy of U-shaped Multi-point Suture Fixing Skin Flap and Three-tube Negative Pressure Drainage Preventing Effusion After Modified Radical Mastectomy

目的 探讨U型多点缝合固定皮瓣及三管负压引流预防乳腺癌改良根治术Ⅰ式术后积液的效果。方法 选取158例行乳腺癌改良根治术Ⅰ式患者为研究对象,根据不同的皮瓣缝合方式将患者分为观察组(n=78)和对照组(n=80),观察组采取U型多点缝合固定皮瓣及三管负压引流,对照组采取常规缝合及引流方式,术后比较两组患者手术相关并发症的发生率、术后引流量、皮瓣及腋窝置管时间和住院时间。结果 观察组术后出现皮下积液8例(10.26%),低于对照组的23例(28.75%),观察组发生皮瓣坏死1例(1.28%),低于对照组的8例(10.00%),组间比较差异均有统计学意义(P均<0.05)。观察组术后1~5天引流量均显著低于对照组(P均<0.001)。观察组术后皮瓣置管时间、腋窝置管时间及患者住院时间较对照组均明显缩短(P均<0.001)。结论 U型多点缝合固定皮瓣及三管负压引流较常规缝合引流能有效减少术后积液量,降低皮下积液及皮瓣坏死的发生率,缩短患者引流管置管时间及住院时间。

Objective To investigate the efficacy of U-shaped multi-point suture fixing skin flap and three-tube neg-ative pressure drainage on preventing effusion after modified radical mastectomy typeⅠ.Methods A total of 158 patients undergoing modified radical mastectomy typeⅠwere selected as the study objects,and the patients were divided into ob-servation group(n=78)and control group(n=80)according to different types of skin flap suture,the observation group received U-shaped multi-point suture fixing skin flap and three-tube negative pressure drainage,while the control group received conventional suture and drainage method,the incidence of surgical complications,postoperative drainage volume,skin flap and axillary catheterization time and hospitalization time of patients between the two groups were compared.Results Postoperative subcutaneous effusion occurred in 8 cases(10.26%)in the observation group,which were 23 ca-ses(28.75%)lower than those in the control group,1 case(1.28%)of skin flap necrosis occurred in the observation group,which were 8 cases(10.00%)lower than those in the control group,and there was a statistically significant difference between the two groups(all P<0.05).The drainage volume of the observation group was significantly lower than that of the control group 1-5 days after surgery(all P<0.001).The time of skin flap catheterization,axillary cathe-terization and hospitalizationl time in the observation group were significantly shorter than those in the control group(all P<0.001).Conclusion Compared with conventional suture and drainage method,U-shaped multi-point suture fixing skin flap and three-tube negative pressure drainage can effectively reduce the postoperative effusion drainage volume,low-er the incidence of subcutaneous effusion and skin flap necrosis,and shorten the duration of drainage tube placement and hospitalization time of the the patients.