乳腺癌术后皮瓣引流有效负压阈值的临床研究

Clinical study on effective negative pressure threshold of skin flap drainage after breast cancer surgery

[目的]探讨乳腺癌术后皮瓣引流压力的有效阈值。[方法]将360例行乳腺癌改良根治术后放置皮瓣引流病人随机分为放置-20kPa引流装置组(A组)120例,-80kPa引流装置组(C组)120例,-95kPa引流装置组(B组)120例,比较3组引流装置引流效果、并发症发生情况、病人治疗积极性以及医护患满意度。[结果]C组术后第1天、第2天、第3天引流量分别为(170±24)mL、(115±15)mL、(100±10)mL,高于其他两组;引流管留置时间,皮下积液、皮瓣坏死、切口裂开发生率及切口疼痛程度均低于其他两组,在满意度及治疗积极性方面明显优于其他两组,差异有统计学意义(P<0.01或P<0.05)。[结论]-80kPa的压力为乳腺癌术后切口引流的有效阈值,能有效减少乳腺癌术后切口相关并发症,提高病人舒适度及治疗积极性,显著提高医护患三方满意度。

Objective:To probed into the effective negative pressure threshold of skin flap drainage after breast cancer surgery.Methods:A total of 360 patients placed the skin flap drainage after breast modified radical surgery were randomly divided into-20 kPa drainage device group(group A)120cases,-80 kPa drainage device group(Group C)120 cases,-95 kPa drainage device group(group B)120 cases,they were compared in three groups on drainage effect of drainage device,complication occurrence,activity of patients treatment and doctorsnurses-patients satisfaction.Results:Drainage volume of postperative the first day,second days,third days were respectively(170±24)mL,(115±15)mL,100±10mL in group C which were higher than that in the other two groups.While they were lower than the other two groups aspects of in drainage tube indwelling time,hypodermic hydrops,skin flap necrosis,incidence of wound dehiscence and wound pain degree.It was better than the other two groups in aspects of activity of treatment and satisfaction,and there were statistically significant differences(P<0.01 or P<0.05).Conclusion:-80 kPa pressure was the effective threshold for postoperative incision drainage of breast cancer patients,which could effectively reduce postoperative incision related complications of breast cancer patients,improve patients comfort and activity of treatment and significantly improve doctors-nurses-patients satisfaction.