淋巴显像及术中γ探测结合专利蓝Ⅴ染色预防腹股沟区切口淋巴瘘  

The clinical analysis of radioclide imaging and patent blue V in prevention of lymphorrhea after operations in fold inguen＇ s space prospective randomized trial

作　　者：张居文[1] 陈萍[1] 杨牟[1] 孙林[1] 车海杰[1] 勇俊[1] 李鲁滨[1] 宋富波[1] 

机构地区：[1]青岛大学医学院附属烟台毓璜顶医院血管外科,264000

出　　处：《中华实验外科杂志》2012年第10期2073-2075,共3页Chinese Journal of Experimental Surgery

基　　金：烟台市科技发展计划资助项目（2008602）

摘　　要：目的应用淋巴显像及术中1探测结合专利蓝V染色探测切口内淋巴结与淋巴管，能在术中及时避免并发现切口内淋巴结及淋巴管的损伤，并采取有效措施避免术后切口淋巴瘘的发生。方法将符合纳入标准的患者分为实验组和对照组各20例，实验组均应用核素扫描并专利蓝V示踪技术进行早期诊断和干预治疗，而对照组不施行该项技术，比较两组术后切口淋巴液日均引流量和总引流量、拔管时间以及淋巴瘘的发生率。结果实验组术后4d切口淋巴液总引流量为（125．1±23．7）ml，对照组为（369．9±31．7）ml，两者比较总引流量减少59．6％（P〈0．05）；实验组无1例发生淋巴瘘，对照组有2例发生淋巴瘘；发生淋巴瘘患者引流管留置天数为（10．2±2．5）d，术后住院天数为（19．5±4．5）d，伤口并发症1例（50％），无淋巴瘘患者引流管留置天数为（3．5±0．8）d，术后住院天数为（7．6±1．2）d，伤口并发症人数为0，两者比较差异有统计学意义（P〈0．01）。结论应用核素扫描并专利蓝V示踪技术处理的患者较对照组淋巴瘘的发生率低（P〈0．05），且切口淋巴引流量明显减少，拔管时间缩短。Objective To evaluate the clinical effect of radioclide imaging and Patent Blue V on lymphorrhea after operations in fold inguen＇ s space. To use radioclide imaging and Patent Blue V to prevent or cure lymphorrhea, so we can lower the incidence of lymphorrhea at the most. Methods Fourty patients undergoing operated in fold inguen＇ s space were randomized into tWO group ： control group （ n = 20） without using radioclide imaging and Patent Blue V and treatment group （n =20） with this technology applied to the dissection area at the begin of the surgical procedure. For each group, the mean daily postoperative drainage volume, the mean cumulative drainage quantity 4 days after operation and the incidence of lymphorrhea were reported. The analysis was used to evaluate the medical effect of using radioclide imaging and Patent Blue V in surgery in fold inguen＇ s space. It was logical to hope that application of Radioclide imaging and Patent Blue V after operations in fold inguen＇ s space would reduce lymphorrhea. Results The mean daily postoperative drainage was significantly greater in control group （P 〈 0. 05 ）. The mean cumulative drainage quantity 4 days after the operation was （ 125. 1 ± 23.7 ） ml and （ 369. 9 ± 31.7 ） ml in treatment group and control group respectively, the reduction of cumulative drainage was 59. 6% （P 〈 0. 05）. The incidence of lyrnphorrhea was 0% （0 cases） and 10% （2 cases） in treatment group and control group respectively. （P 〈 0. 05）. One wound complications （50%） occurred in patients with postoper- ative lymphorrhea, and 0 （0%） occurred in those without postoperative lymphorrhea （P 〈 0. 01 ）. The total drainage duration and mean postoperative hospital stay was （ 10. 2 ± 2. 5） and （ 19. 5± 4. 5） days in lymphorrhea group, there were （ 3.5 ± 0. 8 ） and （7. 6± 1.2） days in goupe without lymphorrhea （ P 〈 0. 05）. Conclusion Radioclide imaging and Patent Blue V can reduce the daily and total cumulative

关 键 词：核素扫描 专利蓝V 示踪 预防 淋巴瘘 

分 类 号：R656[医药卫生—外科学]