皮瓣游离方法不同对乳腺癌局部复发率的影响

The effect of different skin flap dissociating approaches on local relapse rates of breast cancer

目的 探讨乳腺癌手术时不同的皮瓣游离方法对皮瓣近期并发症及复发率的影响。方法 采用随机分组的方法,在手术时采用不同的皮瓣游离方法,A组为电刀游离,B组为皮下注射生理盐水+肾上腺素后普通刀片游离,C组为皮下注射生理盐水+肾上腺素+甲氨蝶呤+5-Fu的皮瓣游离方法,其他治疗方法原则上统一。结果 皮瓣的近期并发症A与B、C两组比较差异有显著性(P<0.05);局部复发率A、C与B组比较差异有显著性(P<0.05)。结论 乳腺癌手术时采用皮下注射生理盐水+肾上腺素+甲氨蝶呤+5-Fu的皮瓣游离方法具有皮瓣近期并发症少、局部复发率低的优点。

Objective To investigate the effect of different skin flap dissociating approaches in breast cancer operation on short-term skin flap complications and local relapse rate. Methods All patients were randomly devided into 3 groups according to different skin flap dissociating approaches: group A was dissociation by elect-rotome, group B was dissociation by scalpel after subcutaneous injection of normal saline( NS) and adrenalin , group C was dissociation by scalpel after subcutaneous injection of NS, adrenalin, MTX and 5-Fu.The other treatment methods were identical. Results The short-term complications were significantly different between group A and group B or C(P<0.05). The local relapse rates were different between group A or C and group B ( P < 0.05) . Conclusions It is advantageous to inject NS,adrenalin, MTX before 5-Fu under skin before dissociating skin flap in breast cancer operation,which results in decrease in short-term complications and local relapse rate.