引流方式对乳腺癌改良根治术后皮瓣坏死的影响  

Influence of the Drainage Way to the Healing of the Skin Flap after the Modified Radical Mastectomy

作　　者：万厚民[1] 张应丽[1] 李金文[1] 秦士勇[1] 王辉[1] 李海[1] 王震宇[1] 

机构地区：[1]山东省济南市第四人民医院普外科,250031

出　　处：《中国全科医学》2006年第10期803-804,共2页Chinese General Practice

摘　　要：目的探讨不同引流方式对乳腺癌改良根治术后皮瓣坏死的影响。方法1999年7月～2005年4月106例行乳腺癌改良根治术的患者,均采用Stewart横切口,术后随机采用两种方式进行引流,A组采用单纯闭式持续负压引流,B组采用胸壁绷带加压包扎加闭式负压引流。结果两组患者发生皮瓣坏死的情况:A组轻度7例,中度4例,重度2例;B组轻度10例,中度7例,重度6例,两组间差别有显著性意义(P=0.032)。结论乳腺癌术后单纯闭式负压引流效果较好,绷带加压包扎加闭式负压引流有增加皮瓣坏死的风险,不宜提倡。Objective To study the influence of different drainage ways to the healing of skin flap after modified radical mastectomy. Methods 106 patients with breast carcinoma were performed modified radical operation with Stewart iaeision and randomly applied one of the two drainage ways. In group A, the simple closed continuous suction drainage was performed; in group B, the compression bandaging on chest wall with bandage combined with closed continuous suction drainage was performed. The cases were divided into three groups according to the range of necrosis of the skin flap, the mild degree was less than or equal to 2. 0 cm, the moderate degree was 2. 1 -5, 0 cm, and the severe degree was more than 5. 0 cm. Results There were 13 cases （7 cases were mild degree, 4 were moderate degree, 2 were severe degree） occured skin flap necrosis in group A and 23 cases （10 were mild degree, 7 were moderate degree, 6 were severe degree） in group B. There was significant difference in the two groups （ P =0. 032）. Conclusion It is better to apply the simple closed suction drainage for the patients with breast carcinoma who ape performed modified radical operation , because this way may minimize the necrosis Pate of the skin flap. The compression bandaging on chest wall with bandage combined with closed continuous suction drainage shouhl be given up because it may increase the necrosis rate of the skin flap.

关 键 词：乳腺肿瘤 改良根治术 皮瓣坏死 引流 

分 类 号：R737.9[医药卫生—肿瘤]