超声引导下抽液联合高渗葡萄糖冲洗治疗乳腺癌术后皮下积液的临床价值  

Clinical value of ultrasound-guided aspiration combined with hypertonic glucose flushing in treatment of postoperative subcutaneous effusion in patients with breast cancer

作　　者：章美武 吕淑懿 范晓翔 庄鲁辉 裘玉琴 张柏松 张燕 Zhang Meiwu;Lyu Shuyi;Fan Xiaoxiang;Zhuang Luhui;Qiu Yuqin;Zhang Baisong;Zhang Yan(Department of Interventional Therapy,Hwa Mei Hospital,University of Chinese Academy of Sciences,Ningbo 315010,China)

机构地区：[1]中国科学院大学宁波华美医院介入治疗科,浙江宁波315010

出　　处：《中华医学超声杂志（电子版）》2023年第3期327-331,共5页Chinese Journal of Medical Ultrasound(Electronic Edition)

基　　金：浙江省医药卫生科技计划项目(2020KY834,2020KY837,2021KY294)。

摘　　要：目的探讨超声引导下穿刺抽液+50%高渗葡萄糖冲洗对治疗乳腺癌根治术后皮下积液的可行性和临床应用价值。方法回顾性收集2019年1月至2021年3月在中国科学院大学宁波华美医院行单侧乳腺癌根治术或者改良根治术,并术后拔管后出现皮下积液的患者89例。完全随机分为常规抽液组(31例)、超声引导下穿刺抽液组(28例)和超声引导下穿刺抽液+50%高渗葡萄糖冲洗治疗组(30例)。采用单因素方差分析比较3组患者抽吸的总积液量、穿刺次数和治愈时间的差异,并采用SNK检验进行组间两两比较。结果超声引导穿刺抽液+50%高渗葡萄糖冲洗治疗组总积液量为(41.31±12.36)ml,穿刺次数为(2.83±0.79)次,治愈时间为(15.37±2.75)d,均低于常规抽液组[(50.67±12.10)ml,(4.61±1.12)次,(26.39±4.98)d],差异均具有统计学意义(P均<0.05);上述指标也均低于超声引导下抽液组[(44.69±15.72)ml,(3.36±1.25)次,(19.00±2.09)d],其中治愈时间比较,差异具有统计学意义(P<0.05)。结论超声引导下穿刺抽液联合50%高渗葡萄糖冲洗治疗乳腺癌术后皮下积液有效,减轻了患者的痛苦,缩短了治疗时间。Objective To explore the feasibility and clinical value of ultrasound-guided aspiration combined with 50%hypertonic glucose flushing in the treatment of subcutaneous effusion in patients with breast cancer after radical mastectomy.Methods A retrospective analysis was performed on 89 patients who underwent unilateral radical mastectomy or modified radical mastectomy at Ningbo Hwamei Hospital of the University of Chinese Academy of Sciences from January 2019 to March 2021,and had subcutaneous effusion after extubation after surgery.The patients were completely randomly divided into a conventional aspiration group(31 cases),an ultrasound-guided aspiration group(28 cases),and an ultrasonic-guided aspiration+50%hypertonic glucose flushing group(30 cases).The total amount of fluid aspirated,the number of punctures in the hospital,and the healing time were compared among the three groups by one-way analysis of variance,and pairwise comparisons between groups were performed using the SNK test.Results The total amount of fluid aspirated,the number of punctures,and the healing time were(41.31±12.36)ml,(2.83±0.79)times,and(15.37±2.75)d,respectively,in the ultrasound-guided aspiration combined with hypertonic glucose flushing group,which were significantly lower than those in the conventional aspiration group[(50.67±12.10)ml,(4.61±1.12)times,and(26.39±4.98)d,respectively;P<0.05]and the ultrasound-guided aspiration group[(44.69±15.72)ml,(3.36±1.25)times,and(19.00±2.09)d,respectively;P<0.05].Conclusion Ultrasound-guided aspiration combined with 50%hypertonic glucose flushing is effective in the treatment of subcutaneous effusion in patients with breast cancer after radical mastectomy,and it reduces the pain of patients and shortens the treatment time.

关 键 词：乳腺癌 皮下积液 超声引导 高渗葡萄糖 穿刺抽液 

分 类 号：R445.1[医药卫生—影像医学与核医学] R563[医药卫生—诊断学]