两种皮瓣分离方式对乳腺癌改良根治术伤口的影响  

A Comparative Study of Two Skin Flap Dissection Methods for Modified Radical Mastectomy

作　　者：刘海[1] 符勇[2] 朱晒红[1] 杨文龙[1] 杨湘武[1] 

机构地区：[1]中南大学湘雅三医院外科,410013 [2]海南省人民医院肿瘤外科,570311

出　　处：《实用癌症杂志》2007年第1期73-74,共2页The Practical Journal of Cancer

摘　　要：目的比较肾上腺盐水皮下浸润后手术刀片游离皮瓣和电刀游离皮瓣对乳腺癌改良根治术伤口的影响。方法自2002年1月至2006年9月实施Auchincloss乳腺癌改良根治术者130例,均采用横切口,肾上腺盐水皮下浸润后手术刀片游离皮瓣组75例(A组),电刀游离皮瓣55例(B组)。结果A组发生皮瓣坏死共6例(8.0%),均经换药治疗后痊愈;B组发生皮瓣坏死18例(32.7%),其中3例需植皮治疗,两组比较有非常显著性差异(P<0.01);A组发生皮下积液3例(4.0%),B组发生皮下积液8例(14.6%),两组比较有显著性差异(P<0.05)。Objective To investigate the different influence of electrocautery and surgical scalpel dissection with epinephrine on the wound of modified mastectomy for breast cancer. Methods Between Jan. 2002 and Sep. 2006,130 case were undergone Auchincloss modified mastectomy, of which skin flap was dissected with surgical scalpel following subcutaneous injection of 1：200 epinephrine saline solution in 75 cases （ Group A）, skin flap was dissected with electrocautery in 55 cases （ Group B）. Results Postoperative flap necrosis occurred in 6 cases （ 8.0% ） in Group A, and all of them were cured with local conservative treatment, it was significantly lower compared with 18 cases （32.7%）, of which 3 cases need skin graft in Group B （P 〈 0.01 ） ; Postoperative seroma occurred in 3 cases（4.0% ） in Group A ,which was significantly lower compared with 8 cases（ 14.6% ） in Group B （P 〈 0.05 ）. Conclusion Scalpel dissection following subcutaneous injection of epinephrine saline solution is a safe,effective,and hence recommendable method in skin flap management for modified mastectomy.

关 键 词：乳腺癌改良根治术 手术刀皮瓣游离 肾上腺素 皮瓣坏死 皮下积液 

分 类 号：R737.9[医药卫生—肿瘤]