镍钛合金记忆线皮内缝合技术对乳腺癌改良根治术后切口美容效果及放射性皮肤损伤的影响  

Effects of Ni-Ti memory alloy wire for intradermal suture technique on cosmetic results of incision after modified radical mastectomy and radiation skin injury in patients with breast cancer

作　　者：于娇[1] 王健生[2] 秦思达[2] 孙欣[2] 任宏[2] 赵阳[3] 李金茂 李刚 YU Jiao;WANG Jiansheng;QIN Sida;SUN Xin;REN Hong;ZHAO Yang;LI Jinmao;LI Gang(Department of Radiation Oncology,Shaanxi Provincial People's Hospital,Shaanxi Xi'an 710068,China;Department of Thoracic Surgery,the First Affiliated Hospital of Medical College of Xi'an Jiaotong University,Shaanxi Xi'an 710061,China;Department of Oncology Surgery,the Second Affiliated Hospital of Medical College of Xi'an Jiaotong University,Shaanxi Xi'an 710004,China;Department of Nail and Breast Surgery,Xi'an Daxing Hospital,Shaanxi Xi'an 710016,China)

机构地区：[1]陕西省人民医院放疗科,陕西西安710068 [2]西安交通大学第一附属医院胸外科,陕西西安710061 [3]西安交通大学第二附属医院肿瘤外科,陕西西安710004 [4]西安大兴医院甲乳外科,陕西西安710016

出　　处：《现代肿瘤医学》2022年第17期3133-3138,共6页Journal of Modern Oncology

基　　金：国家自然科学青年基金项目(编号:81872390);陕西省重点研发计划项目(编号:2021SF-306)。

摘　　要：目的:探究镍钛合金记忆线皮内缝合技术对乳腺癌改良根治术后切口美容效果及放射性皮肤损伤的影响。方法:回顾性分析2016年04月至2021年01月98例行乳腺癌改良根治术患者相关资料,依据患者术后缝合方式分为试验组(n=50)和对照组(n=48),分别采用镍钛合金记忆线皮内缝合技术和传统丝线间断缝合技术。采用温哥华瘢痕评估量表(Vancouver scar scale,VSS)对两组患者手术切口瘢痕情况进行评估比较,采用自制的调查问卷对两组患者手术区域美容效果满意度进行调查比较。采用放射治疗肿瘤协作组(Radiation Therapy Oncology Group,RTOG)急性放射损伤分级标准对两组接受术后放疗患者急性放射性皮肤损伤情况进行对比观察。结果:试验组患者的VSS总评分明显低于对照组,差异具有统计学意义(P<0.05);且试验组患者VSS的血管分布、色泽、柔软度、厚度4个特点评分均明显低于对照组,差异具有统计学意义(P<0.05)。试验组患者总体满意率(92.00%)和满意度级别均明显高于对照组(52.08%),差异具有统计学意义(P<0.05)。所有放疗患者均出现急性放射性皮肤损伤,试验组3、4级急性放射性皮肤损伤的发生率明显低于对照组,差异具有统计学意义(P<0.05);试验组急性放射性皮肤损伤发生级别明显低于对照组,差异有统计学意义(P<0.05)。结论:乳腺癌改良根治术切口缝合时采用镍钛合金记忆线皮内缝合技术可以有效抑制术后瘢痕形成,美容效果好,患者满意度高,同时对降低术后放疗患者急性放射性皮肤损伤的发生率和严重程度也起到了积极的作用,值得进一步探索和推广。Objective:To explore the effects of Ni-Ti memory alloy wire for intradermal suture technique on cosmetic results of incision after modified radical mastectomy and radiation skin injury in patients with breast cancer.Methods:A retrospective analysis was performed on related data of 98 patients who underwent modified radical mastectomyfrom April 2016 to January 2021.According to postoperative suture methods,they were divided into the test group(n=50)and the control group(n=48).The two groups were given nitinol memory alloy intradermal suture and silk interrupt suture,respectively.Vancouver scar scale(VSS),self-made questionnaire and Radiation Therapy Oncology Group(RTOG)acute radiation injury grading standard were separately used to compare the condition of postoperative scar,patients'satisfaction with cosmetic effect in operation area and the acute radiation skin injury between the two groups.Results:The VSS score of the test group was significantly lower than that of the control group(P<0.05),and the vascular distribution,color,softness and thickness of VSS in the test group were also significantly lower than those in the control group(P<0.05).The overall satisfaction rate and satisfaction level of patients in the test group(92.00%)were significantly higher than those in the control group(52.08%)(P<0.05).All patients had acute radiation skin reaction.The incidence of grade 3 and 4 acute radiation skin reaction in the test group was significantly lower than that in the control group(P<0.05).The level of acute radiation skin injury in the test group was significantly lower than that in the control group(P<0.05).Conclusion:Ni-Ti memory alloy skin suture technique can effectively inhibit postoperative scar formation and improve cosmetic results,and win more patient satisfaction.It also plays a positive role in reducing the incidence and severity of acute radiation skin injury after radiotherapy,and is worthy of further exploration and promotion.

关 键 词：镍钛合金记忆线皮内缝合 乳腺癌改良根治术 瘢痕 美容效果 

分 类 号：R737.9[医药卫生—肿瘤]