超声刀在乳腺癌腋窝淋巴结清扫术中的应用及效果评价  

Application and evaluation of harmonic scalpel in breast cancer surgery,axillary lymph node dissection

作　　者：王东风[1] 唐金海[1] 秦建伟[1] 任广辉[2] 马小凯[1] 朱正志[1] 

机构地区：[1]南京医科大学附属肿瘤医院(江苏省肿瘤医院)普外科,江苏南京210009 [2]南京市第二医院外科,江苏南京210003

出　　处：《中国肿瘤外科杂志》2015年第1期30-32,共3页Chinese Journal of Surgical Oncology

摘　　要：目的探讨超声刀在乳腺癌腋窝淋巴结清扫术中的临床应用价值。方法以2012年6月至2013年7月期间收治的行乳腺癌改良根治术患者152例为研究对象,其中63例术中采用超声刀清扫腋窝淋巴结(超声刀组),89例采用高频电刀(电刀组),比较两组手术时间、术中出血量、术中副损伤、术后引流量、引流管留置时间、淋巴结检出数目和皮下积液的发生情况。结果超声刀组与电刀组相比较,手术时间和淋巴结检出数目的差异无统计学意义(P>0.05);术中出血量、术后引流量、引流管留置时间及皮下积液的发生率,超声刀组均较电刀组减少,差异有统计学意义(均P<0.05);两组均无血管、神经等副损伤。结论在乳腺癌改良根治术中应用超声刀清扫腋窝淋巴结安全、可行,具有创伤小、术中出血少、并发症发生率低等优点。Objective To investigate the value on clinical application of ultrasonically activated-scalpel in axillary lymph node dissection compared with electro-surgery. Methods 152 cases of breast cancer were enrolled in this study from June 2012 to July 2013. All patients were divided into two groups,63 cases were operated by ultracision harmonic scalpel; 83 cases were operated by electrosurgical scalpel. Operation time,amount of bleeding and subsidiany injury during operation,post-operative suction drainage,time of drainage tube exelcymosis,amount of lymph node,subcutaneous hydrops and complications were observed and recorded accordingly. Results There was no obvious difference in operating time and amount of lymph node between the two groups. However,amount of bleeding and drainage,the time of drainage tube exelcymosis and the incidence of subcutaneous hydrops in ultracision harmonic scalpel group were significantly less than those in electrosurgical scalpel group. Conclusions Using ultracision harmonic scalpel in breast cancer operation is a safe and effective surgery procedure. Ultracision harmonic scalpel has the advantage of little trauma,less bleeding and less complications. It is worth promoting for the good prospect of further application.

关 键 词：乳腺癌改良根治术 腋窝淋巴结清扫术 超声刀 高频电刀 

分 类 号：R737.9[医药卫生—肿瘤]