肿胀局麻技术在乳腺癌手术中的应用研究  

The application of tumescent technique on modified radical mastectomy

作　　者：叶永强 蔡联明 蓝小林 谢旭平 王勇斌 张相民 

机构地区：[1]江西省赣州市肿瘤医院,341000

出　　处：《中国现代药物应用》2008年第24期31-33,共3页Chinese Journal of Modern Drug Application

摘　　要：目的探讨乳腺癌改良根治术中肿胀技术的应用价值。方法将赣州市肿瘤医院2006年8月至2008年3月在硬膜外麻醉下施行的乳腺癌改良根治术患者随机分为两组:肿胀技术组53例,常规组53例,观察两组术中及术后镇痛效果,统计两组术中出血量、手术时间、术后皮下积液及皮瓣坏死发生率。结果肿胀技术组术中及术后镇痛效果明显优于常规组(P<0.01),手术出血量、手术时间均明显少于常规组(P<0.01),术后皮下积液(P<0.05)及皮瓣坏死发生率(P<0.01)也明显低于常规组。结论在硬膜外麻醉下施行的乳腺癌改良根治术中应用肿胀技术,具有良好的术中及术后镇痛效果,并可以减少手术出血量,缩短手术时间,降低术后皮下积液及皮瓣坏死发生率,值得推广应用。Objective To discuss the practical value of tumescent technique in modified radical mastectomy. Methods To randomize the patients who accepted the modified radical mastectomy in eqidural anesthesia in our hospital from August 2006 to March 2008 into two groups according to the sequencial order. And one group took tumescent technique, including 53 patients, the other group only took the conventional modified radical mastectomy, also 53 included. Then we observed the effect of intraoperative and postoperative analgesia of the two groups and calculated the quantity of bleeding in the process of the operation, how much time the operation took, and the probability of subcutaneous effusion and skin flap necrosis after the operation of the two groups. Results Obviously, patients who took the tumescent technique had a better effect of intraoperative and postoperative analgesia than the conventional group（P 〈 0.01 ）. The tumescent needed the less operating time and bleeding during the operation than the conventional（ P 〈 0. 01 ）, and in the probability of subcutaneous effusion（ P 〈 0. 05 ） and skin flap necrosis （ P 〈 0. 01 ） after the operation of the tumescent was also noticeably lower than the conventional one. Conclusions Applying tumescent technique to the modified radical mastectomy with epidural anesthesia has obvious antalgic effect during and after the operation, and it can also reduce the quantity of bleeding during the operation, shorten the time which one operation takes and let down the possibility of subcutaneous effusion and skin flap necrosis. It is worth promotion.

关 键 词：乳腺癌改良根治术 肿胀技术 临床应用 

分 类 号：R737.9[医药卫生—肿瘤] R655.8[医药卫生—临床医学]