腋周组织瓣即刻修复在行淋巴清扫乳腺癌患者中的应用  

Application of immediate repair of axillary tissue flap on patients with breast cancer after lymphadenectomy

作　　者：赵北永 宋晓丹[1] 关华鹤[1] ZHAO Beiyong;SONG Xiaodan;GUAN Huahe(Department of Thyroid and Mammary Surgery,Central Hospital of Zhoukou City,Henan Zhoukou 466000,China)

机构地区：[1]周口市中心医院甲状腺乳腺外科,河南周口466000

出　　处：《现代肿瘤医学》2020年第23期4107-4110,共4页Journal of Modern Oncology

摘　　要：目的:探讨腋周组织瓣即刻修复对行淋巴清扫乳腺癌患者术后淋巴瘘发生风险、上肢功能及满意度的影响。方法:选取我院2016年3月至2017年3月收治行淋巴清扫乳腺癌患者共116例,随机分为对照组(58例)和观察组(58例),分别采用腋周组织瓣非即刻和即刻修复方案治疗;比较两组患者引流量、引流时间、患肢/健肢细胞内外液差值、淋巴瘘发生率、上肢功能障碍程度比例、腋窝外形McCarthy评分及腋窝舒适度Kolcaba评分。结果:观察组患者术后引流量、引流时间及患肢/健肢细胞内外液差值均显著少于对照组(P<0.05);观察组患者术后淋巴瘘发生率显著低于对照组(P<0.05);观察组患者上肢功能障碍程度比例显著低于对照组(P<0.05);观察组患者腋窝外形McCarthy评分和舒适度Kolcaba评分均显著高于对照组(P<0.05)。结论:腋周组织瓣即刻修复对行淋巴清扫乳腺癌患者可有效减少术后引流量和时间,预防淋巴瘘发生,改善上肢功能,并有助于提高外形满意度和舒适度。Objective:To investigate the influence of immediate repair of axillary tissue flap on lymphatic fistula risk,upper limb function and satisfaction of patients with breast cancer after lymphadenectomy.Methods:116 patients with breast cancer after lymphadenectomy were chosen in the period from March 2016 to March 2017 and randomly divided into control group(58 patients)without immediate repair of axillary tissue flap and observation group(58 patients)with immediate repair of axillary tissue flap,and the drainage volume,drainage time,ECWd/ICWd,the lymphatic fistula incidence,the proportion of upper limb dysfunction,the McCarthy score of axillary shape and the Kolcaba score of armpit comfort of both groups were compared.Results:The drainage volume,drainage time and ECWd/ICWd of observation group were significantly less than control group(P<0.05).The lymphatic fistula incidence of observation group was significantly lower than control group(P<0.05).The proportion of upper limb dysfunction of observation group was significantly lower than control group(P<0.05).The McCarthy score of axillary shape and the Kolcaba score of observation group were significantly higher than control group(P<0.05).Conclusion:Immediate repair of axillary tissue flap in the treatment of patients with breast cancer after lymphadenectomy can efficiently decrease postoperative drainage volume and time,prevent lymphatic fistula,improve upper limb function and be helpful to higher appearance satisfaction and comfort degree.

关 键 词：皮瓣修复 淋巴清扫 乳腺癌 淋巴瘘 上肢功能 满意度 

分 类 号：R737.9[医药卫生—肿瘤]