乳腺癌患者术后置管时间影响因素研究  

Influential factors of postoperative drainage time for breast cancer patients

作　　者：林晓丹[1,2] 王华珍[3] 郑婉婷[2] 李建文[2] 刘雯雯[4] 莫美珍[4] 

机构地区：[1]汕头大学医学院第一附属医院重症医学科,515000 [2]广东医学院附属医院乳腺外科,湛江524001 [3]广东医学院附属医院护理部,湛江524001 [4]广东医学院附属医院手术室,湛江524001

出　　处：《中华乳腺病杂志（电子版）》2015年第5期307-311,共5页Chinese Journal of Breast Disease(Electronic Edition)

摘　　要：目的研究乳腺癌患者术后置管时间的影响因素,探讨缩短置管时间合适的治疗及护理方案。方法采用回顾性研究方法收集2013年7月至2014年9月在广东医学院附属医院收治病理诊断为乳腺癌、行改良根治术、术中留置引流管的210例患者的临床病理资料。分析体质指数、淋巴结肿大数量、肿物数量、高血压、糖尿病、纤维蛋白原、白细胞、红细胞、术前化疗等23个影响因素对乳腺癌患者术后留置引流管时间的影响。单因素分析采用t检验和方差分析,多因素分析采用非条件Logistic回归分析。结果单因素分析结果显示:在不同体质指数、肿块面积、收缩压、凝血时间、纤维蛋白原、白细胞计数、肿物数量、临床分期、皮下积液、上肢淋巴水肿及是否合并糖尿病的患者之间,术后置管时间的差异均有统计学意义(t=-4.659,t=-1.983,F=5.268,t=3.105,F=7.238,t=-2.571,t=2.984,F=8.650,t=-4.506,t=-5.380,t=-2.219;P均<0.050)。非条件Logistic回归分析显示:体质指数、纤维蛋白原、白细胞计数、皮下积液、上肢淋巴水肿与乳腺癌患者术后置管时间有明显的相关性(OR=1.403、0.335、1.262、4.554、9.559,P均<0.050)。结论体质指数增加、纤维蛋白原减少、白细胞异常增长、发生皮下积液和上肢淋巴水肿将延长乳腺癌术后置管时间,不利于术后进一步辅助治疗。Objective To investigate the influential factors of postoperative drainage time for breast cancer patients and explore the appropriate treatment and nursing scheme to shorten catheterization time. Methods We retrospectively analyzed the clinicopathologieal data of 210 patients pathologically diagnosed with breast cancer who underwent modified radical mastectomy and intraoperative drainage from July 2013 to September 2014 in the Affiliated Hospital of Guangdong Medical College. Totally 23 factors including body mass index（BMI）, number of lymph nodes, number of tumors, hypertension, diabetes, fibrlnogen, white blood cells, red blood cells, preoperative chemotherapy were analyzed to detect their influence on postoperative drainage time in breast cancer patients. Univariate analysis was performed using t test and analysis of variance ; multivariate analysis was conducted using Logistic regression. Results Univariate analysis showed that postoperative drainage time presented a statistically significant difference in the patients with different body mass index, tumor size, systolic blood pressure, clotting time, fibrinogen, white blood cell count, number of tumors, clinical stage, subcutaneous effusion, lymphedema and diabetic combination （ t =-4. 659, t = - 1. 983, F = 5.268, t=3. 105, F=7.238, t=-2.571, t=2.984, F=8.650, t=-4.506, t=-5.380, t=-2.219; all P〈 0. 050）. Logistic regression showed that BMI, fibrinogen, white blood cell count, subcutaneous hydrops and lymphedema were significantly correlated with postoperative drainage time （ OR = 1.403, 0. 335, 1. 262, 4. 554,9. 559,all P〈O. 050）. Conclusion The increased BMI and white blood cell count, decreased fibrinogens, and the development of subcutaneous hydrops and lymphedcma would increase postoperative drainage time, affecting the adjuvant therapy after modified radical mastectomy of breast cancer.

关 键 词：乳腺肿瘤 乳房切除术 改良根治性 引流术 

分 类 号：R737.9[医药卫生—肿瘤]