高压氧辅助治疗对乳腺癌术后皮瓣愈合及血管内皮生长因子和缺氧诱导因子的影响  

Effect of hyperbaric oxygen therapy on the healing of the skin flap,the vascular endothelial growth factor,and hypoxia inducing factor-1αafter the modified radical mastectomy

作　　者：史建军[1] 崔猛胜[1] 白骏恒[1] 杨洁泉[1] 常晓飞[1] 付丽丽[1] 牛鸿兰 Shi Jianjun;Cui Mengsheng;Bai Junheng;Yang Jiequan;Chang Xiaofei;Fu Lili;Niu Honglan(Department of Breast Surgery,Heping Hospital Affiliated to Changzhi Medical College,Changzhi 046000,China)

机构地区：[1]长治医学院附属和平医院乳腺科,山西省长治046000

出　　处：《中华航海医学与高气压医学杂志》2021年第1期39-42,共4页Chinese Journal of Nautical Medicine and Hyperbaric Medicine

摘　　要：目的探究高压氧辅助治疗对乳腺癌手术后皮瓣愈合及血管内皮生长因子(VEGF)和缺氧诱导因子-1α(HIF-1α)的影响。方法选取长治医学院附属和平医院乳腺科2017年1月至2019年6月收治的132例乳腺癌患者作为研究对象,按随机数字表法分为对照组和观察组(每组66例)。对照组采用乳腺癌改良根治术,观察组在对照组治疗基础上给予高压氧辅助治疗。比较2组患者术后切口皮瓣愈合情况,包括愈合时间、引流液情况及疼痛评分。治疗前后,测定2组患者血清VEGF和HIF-1α水平,同时随访观察术后并发症情况。结果观察组患者采用高压氧治疗后皮瓣愈合时间为(10.43±0.96)d,较对照组的(13.81±1.15)d明显缩短;液体引流量、术后1 d及3 d的视觉模拟评分(VAS)均优于对照组,差异有统计学意义(P<0.05)。观察组血清VEGF水平较治疗前明显升高,HIF-1α较治疗前明显下降,且变化幅度显著大于对照组,差异有统计学意义(P<0.05)。观察组术后并发症发生率为3.03%,低于对照组的10.61%,但差异无统计学意义。结论高压氧辅助治疗对乳腺癌改良根治术患者临床疗效显著,其通过降低HIF-1α水平,增加VEGF含量而加快皮瓣愈合,缓解患者疼痛,改善预后。Objective To explore the effect of hyperbaric oxygen(HBO)therapy on the healing of the skin flap,the vascular endothelial growth factor(VEGF)and hypoxia inducing factor-1α(HIF-1α)after modified radical mastectomy.Methods A total of 132 patients with breast cancer admitted in the Department of Breast Surgery of Heping Hospital Affiliated to Changzhi Medical College from January 2017 to June 2019 were selected as the research subjects and randomly divided into control group(n=66)and observation group(n=66).The control group was given the modified radical mastectomy,while the observation group was additionally given hyperbaric oxygen therapy.The postoperative healing condition of incision flap,including healing time,drainage volume,and pain score,was compared between two groups.And the serum VEGF and HIF-1αlevels of patients in the two groups were compared before and after the treatment.Besides,postoperative complications were also observed.Results The healing time of the skin flap in the observation group with HBO[(10.43±0.96)d]was significantly shorter than that in the control group[(13.81±1.15)d].The drainage volume of the observation group was(274.01±13.10)ml,and the visual analogue scale(VAS)were(4.02±0.34)and(2.84±0.30)on the first and the third day after the operation respectively.The healing condition and VAS scores of the observation group were both better than those in the control group,and all the differences were statistically significant(P<0.05).Serum VEGF and HIF-1αlevels in the observation group were(809.67±40.22)pg/ml and(243.71±22.84)pg/ml respectively,which were significantly improved compared with those before the treatment and those of the control group,and all the differences were statistically significant(P<0.05).The incidence of postoperative complications in the observation group(3.03%)was lower than that of the control group(10.61%).Conclusion The hyperbaric oxygen therapy has a significant clinical effect on the patient after the modified radical mastectomy.It can accelerate skin

关 键 词：高压氧辅助治疗 乳腺癌改良根治术 皮瓣愈合 血管内皮生长因子 缺氧诱导因子 

分 类 号：R737.9[医药卫生—肿瘤]