乳腺癌根治性手术中皮瓣处理的经验体会  

Experience on the disposal of skin flap in radical mastectomy of breast cancer

作　　者：潘茂华 

机构地区：[1]广西上林县中医院,广西上林530500

出　　处：《现代预防医学》2012年第13期3225-3226,3229,共3页Modern Preventive Medicine

摘　　要：目的探讨乳腺癌根治术中不同皮瓣处理方法对术后皮下积液及切口皮缘坏死的影响。方法回顾性分析某院2003～2009年行乳癌根治术120例患者的临床资料,分析不同皮瓣处理方式对术后皮下积液及切口皮缘坏死情况的影响。结果采用大刀片游离皮瓣组的皮下积液及皮瓣坏死率均明显低于电刀分离法组(P﹤0.05);U型铆钉式缝合组和皮瓣戳孔加压包扎组的皮下积液和皮瓣坏死率均低于皮下置管负压吸引组(P﹤0.05);而U型铆钉式缝合组的皮下积液高于皮瓣戳孔加压包扎组(P﹥0.05),但U型铆钉式缝合组的皮瓣坏死率却低于皮瓣戳孔加压包扎组,但差异无统计学意义(P﹥0.05)。结论大刀片分离皮瓣及皮瓣戳孔加压包扎的术式能有效地减少术后皮下积液和皮瓣坏死的发生率。OBJECTIVE To investigate the effect of different skin flap management methods on post operative subcutaneous fluid and skin flap necrosis after the operation.METHODS A retrospectively analysis of clinical data of 120 cases with breast cancer operated by radical mastectomy in our hospital between 2003-2009 was carried out.The different skin flap management methods were statistically analyzed to compare the postoperative subcutaneous fluid and skin flap necrosis.RESULTS Compared with the electrocautery separation,the subcutaneous fluid and skin flap necrosis were significantly lower than the measure of large blade flap（P﹤0.05）;The subcutaneous fluid and skin flap necrosis of the U-rivet flap suture group and the flap puncture pressure bandage group were lower than subcutaneous suction catheter group（P﹤0.05）,and the subcutaneous fluid of the U-rivet flap suture group was high than the flap puncture pressure bandage group（P﹥0.05）,however,the skin flap necrosis was lower than the flap puncture pressure bandage group（P﹥0.05）.CONCLUSION The methods of the large blade flap and the flap puncture pressure bandage might be effective in reducing postoperative subcutaneous fluid and skin flap necrosis.

关 键 词：乳腺癌 根治术 皮瓣处理 皮下积液 皮瓣坏死 

分 类 号：R737.9[医药卫生—肿瘤]