经下皱襞切口假体隆乳术后负压水平对引流量及患者预后的影响  

Effect of negative pressure level on drain volume and prognosis of patients after prosthetic augmentation mammoplasty through inframammary fold incision

作　　者：赵海洋 王喜梅[1] 董海江[1] 李志斌 谢百慧 闫成祥 Zhao Haiyang;Wang Ximei;Dong Haijiang;Li Zhibin;Xie Baihui;Yan Chengxiang(Medical Beauty Center,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]郑州大学第一附属医院医学美容中心,郑州450052

出　　处：《中华整形外科杂志》2023年第4期375-383,共9页Chinese Journal of Plastic Surgery

摘　　要：目的探讨经乳房下皱襞切口假体隆乳术后不同负压对引流量的影响,并尝试提出能使患者获得最佳预后的负压水平。方法采用随机对照临床研究,选取2019年1月至2021年8月在郑州大学第一附属医院医学美容中心经乳房下皱襞切口行假体隆乳术的患者为研究对象。采用随机数字表法将患者分为4组,术后分别应用不同水平负压引流,其中-80~-85 kPa组、-40~-60 kPa组、-15~-30 kPa组于术后统一应用600 ml可调负压引流瓶;0~-5.2 kPa组于术后应用300 ml引流鼓。引流管拔除标准为24 h引流量小于10 ml且引流液清亮。分别记录4组患者术后每日引流量、引流管放置时间、总引流量、引流装置接受程度及术后并发症等情况。采用SPSS 21.0软件对各组相应指标进行统计学分析,计量资料均以±s表示,多组间比较采用单因素方差分析,组间两两比较采用LSD-t检验,P<0.05为差异有统计学意义。结果共纳入80例患者,每组20例。组间均衡性分析:4组患者年龄、身体质量指数、锁骨中点至同侧乳头距离、乳房下皱襞至同侧乳头距离、乳房组织厚度比较,差异均无统计学意义(P>0.05)。组间疗效评价:术后第1天和第2天引流量,-80~-85 kPa组、-40~-60 kPa组组间差异无统计学意义(P>0.05),其他各组间差异均有统计学意义(P<0.05);术后第3天引流量、总引流量、引流管放置时间4组间两两比较,差异均有统计学意义(P<0.05),负压水平越低术后第3天引流量、总引流量越少,引流管放置时间也越短,其中4组引流管放置时间分别为(5.6±0.7)d(-80~-85 kPa组)、(4.8±0.5)d(-40~-60 kPa组)、(4.0±0.5)d(-15~-30 kPa组)、(3.2±0.4)d(0~-5.2 kPa组)。安全性评价:以单只乳房为计数单位,-80~-85 kPa组、-40~-60 kPa组、-15~-30 kPa组、0~-5.2 kPa组并发症发生率分别为2.5%(1/40)、2.5%(1/40)、0(0/40)和15.0%(6/40),0~-5.2 kPa组并发症发生率最高。引流装置接受度调查(无影响/不满意)�Objective To investigate the effect of different negative pressure level on drain volume after augmentation mammoplasty through inframammary fold incision,and try to put forward the appropriate negative pressure level for the best prognosis of patients.Methods This was a randomized controlled clinical study.Patients who underwent prosthetic augmentation mammoplasty through inframammary fold incision in the Medical Beauty Center of the First Affiliated Hospital of Zhengzhou University from January 2019 to August 2021 were selected as the study subjects.Patients were divided into 4 groups by random number table method and different levels of negative pressure drainage were applied:600 ml adjustable negative pressure drain bottle was used uniformly after operation by-80--85 kPa group,-40--60 kPa group,and-15--30 kPa group.In 0--5.2 kPa group,300 ml drain drum was applied after operation.The criteria for drain removal was that the drain volume within 24 hours was less than 10 ml and the drainage fluid was clear.Daily drain volume,duration of drain placement,total drain volume,acceptance of the drain device and postoperative complications were recorded in the four groups.The corresponding indexes of each group were statistically analyzed by SPSS 21.0.Measurement data were expressed as Mean±SD.One-way analysis of variance was used for comparison between groups,and LSD-t test was used for pair comparison between groups.P<0.05 was considered statistically significant.Results A total of 80 patients were included,20 in each group.Inter-group equilibrium analysis:there was no significant difference in age,body mass index,distance from midclavicular point to nipple,distance from inferior mammary fold to nipple,and breast tissue thickness among 4 groups(P>0.05).Evaluation of curative effect between groups:on the first and second day after operation,there was no significant difference in drain volume between-80--85 kPa group and-40--60 kPa group(P>0.05),but there was significant difference among other groups(P<0.05).There was

关 键 词：乳房植入物 乳房下皱襞切口 负压水平 隆乳术 引流装置接受度 

分 类 号：R655.8[医药卫生—外科学]