"一体化预防策略"用于预防单孔腔镜乳房皮下腺体切除术后乳头乳晕缺血的回顾性研究  

Retrospective study of"integrated prevention strategy"in preventing nipple and areola ischemia after single-port endoscopic subcutaneous mastectomy

作　　者：邢建坤 王子函[2] 徐威 丁国乾 杨小宝 高国璇 屈翔[3] Xing Jiankun;Wang Zihan;Xu Wei;Ding Guoqian;Yang Xiaobao;Gao Guoxuan;Qu Xiang(Anesthesia Operation Center,Beijing Friendship Hospital,Capital Medical University,Beijing 100050,China;Department of Breast Disease,Peking University People′s Hospital,Beijing 100044,China;Department of General Surgery,Beijing Friendship Hospital,Capital Medical University,Beijing 100050,China)

机构地区：[1]首都医科大学附属北京友谊医院麻醉手术中心,北京100050 [2]北京大学人民医院乳腺中心,北京100044 [3]首都医科大学附属北京友谊医院普外分中心,北京100050

出　　处：《国际外科学杂志》2023年第2期81-85,F0004,共6页International Journal of Surgery

基　　金：首都卫生发展科研专项(2020-2-1112);首都医科大学附属北京友谊医院科研启动基金(yyqdkt2018-11)。

摘　　要：目的探讨"一体化预防策略"对单孔腔镜乳房皮下腺体切除术后乳头乳晕缺血的预防价值。方法回顾性分析2019年7月—2021年7于首都医科大学附属北京友谊医院接受单孔腔镜乳房皮下腺体切除术治疗的72例乳腺癌患者的临床资料,均为女性,随访至2022年7月。根据围手术期处理方法不同将患者分为观察组(n=40)和对照组(n=32),观察组患者采用"一体化预防策略"方案,对照组患者采用常规处置方案。比较两组患者术后乳头乳晕缺血的发生率,以及对术后美容效果、患者的生活质量和满意度进行评估。计量资料以均数±标准差(±s)表示,组间比较采用t检验;计数资料组间比较采用χ^(2)检验。结果观察组患者的术后引流量显著少于对照组[(632.40±226.37)mL比(774.91±239.85)mL],差异具有统计学意义(P=0.013)。术后2周乳头乳晕缺血情况:观察组1例,对照组7例,两组比较差异具有统计学意义(P=0.019)。术后12个月,观察组患者的乳房满意度[(83.93±11.64)分比(67.28±11.52)分]、胸壁满意度[(89.63±8.06)分比(83.03±9.49)分]以及社会心理状态[(89.43±12.42)分比(78.88±10.40)分]评分均优于对照组,差异均具有统计学意义(P<0.05)。结论"一体化预防策略"可以有效预防单孔腔镜乳房皮下腺体切除术后乳头乳晕缺血的发生,改善患者满意度,具有一定的推广价值。Objective To explore the preventive value of"integrated prevention strategy"for nipple and areola ischemia after single-port endoscopic subcutaneous mastectomy.Methods The clinical data of 72 patients with breast cancer who received single-port endoscopic subcutaneous mastectomy in Beijing Friendship Hospital,Capital Medical University from July 2019 to July 2021 were retrospectively analyzed,they were all female.The follow-up period was up to July 2022.According to the perioperative treatment methods,the patients were divided into observation group(n=40)and control group(n=32).The patients in the observation group who adopted the"integrated prevention strategy"scheme,and patients in the control group who adopted the conventional treatment scheme.The incidence of postoperative nipple and areola ischemic was compared between the two groups,and the postoperative cosmetic effect,quality of life and satisfaction of patients were evaluated.Measurement data were expressed as mean±standard deviation(±s),and t-test was used for comparison between groups;the Chi-square test was used to compare the data groups.Results The postoperative drainage volume in the observation group was significantly lower than that in the control group[(632.40±226.37)mL vs(774.91±239.85)mL],and the difference was statistically significant(P=0.013).Two weeks after operation,there was 1 case of nipple and areola ischemia in the observation group,and 7 cases in the control group,the difference was statistically significant between the two groups(P=0.019).Twelve months after operation,the score of breast satisfaction(83.93±11.64 vs 67.28±11.52),chest satisfaction(89.63±8.06 vs 83.03±9.49)and psychosocial well-being(89.43±12.42 vs 78.88±10.40)in the observation group were better than those in the control group,the differences were statistically significant(P<0.05).Conclusion"Integrated prevention strategy"can effectively prevent the occurrence of nipple and areola ischemic after single-port endoscopic subcutaneous mastectomy and improve pat

关 键 词：乳腺肿瘤 胸腔镜 手术后并发症 皮下腺体切除术 

分 类 号：R737.9[医药卫生—肿瘤]