双管接负压吸引器引流与传统胸带加压包扎法在乳房下脂肪筋膜瓣保乳整形术中的应用比较  

Comparison of the Application of Double-Tube Negative Pressure Drainage and Traditional Chest Bandage Compression in Breast-Conserving Reconstruction Surgery with Subcutaneous Fat Fascial Flap

作　　者：王俏 边丽娜[1] 仇慧敏 WANG Qiao;BIAN Lina;QIU Huimin(The First Affiliated Hospital of Xi'an Jiaotong University,Shaanxi Xi'an 710061,China)

机构地区：[1]西安交通大学第一附属医院乳腺外科,陕西西安710061

出　　处：《河北医学》2023年第12期2039-2043,共5页Hebei Medicine

基　　金：陕西省自然科学基础研究计划项目(编号:2019JM-553)。

摘　　要：目的:探究双管接负压吸引器引流与传统胸带加压包扎法在乳房下脂肪筋膜瓣保乳整形术中的应用效果。方法:回顾性选取2020年1月至2023年1月在我院接受乳房下脂肪筋膜瓣保乳整形术的患者98例,根据患者的治疗方案将患者分为两组:研究组(n=49)采用双管接负压吸引器引流,对照组(n=49)采用传统胸带加压包扎法引流,对患者进行3个月随访,记录患者术后胸壁拔管时间、腋窝拔管时间、胸壁引流量、腋窝引流量、生命质量测定量表评分、简明疼痛量表(BPI)评分,观察患者术后皮瓣坏死情况、淋巴水肿发生情况及舒适度评分。结果:两组患者术后胸壁拔管时间、腋窝拔管时间比较差异无统计学意义(P>0.05),研究组患者的胸壁引流量、腋窝引流量低于对照组(P<0.05)。两组患者术前的FACT-B、BPI评分比较差异无统计学意义(P>0.05),研究组术前术后FACT-B、BPI评分变化幅度大于对照组(P<0.05)。与对照组患者相比,研究组患者皮瓣坏死发生率较低,且高级别皮瓣坏死发生率比对照组低(P<0.05)。对照组、研究组患者淋巴水肿发生率及严重程度比较差异无统计学意义(P>0.05)。术前两组间舒适度评分比较差异无统计学意义(P>0.05)。与对照组相比,研究组患者术后1d、1月、3月的舒适度均较高(P<0.05)。结论:双管接负压吸引器引流在乳房下脂肪筋膜瓣保乳整形术后引流效果、疼痛缓解方面优于传统胸带加压包扎法,可以其舒适度及生活质量,降低术后皮瓣坏死、淋巴水肿并发症发生。Objective:To explore the application effects of double-tube negative pressure drainage and traditional chest bandage compression in breast-conserving reconstruction surgery with subcutaneous fat fascial flap.Methods:A total of 98 patients who underwent breast-conserving reconstruction surgery with subcutaneous fat fascial flap in our hospital from January 2020 to January 2023 were retrospectively selected.Patients were divided into two groups according to their treatment plans:the study group(n=49)received doubletube negative pressure drainage,and the control group(n=49)received traditional chest bandage compression drainage.Patients were followed up for 3 months,and postoperative chest tube removal time,axillary tube removal time,chest drainage volume,axillary drainage volume,FACT-B score,Brief Pain Inventory(BPI)score were recorded.Postoperative flap necrosis,occurrence of lymphedema,and comfort scores were observed.Results:There was no statistically significant difference in chest tube removal time and axillary tube removal time between the two groups(P>0.05).The chest drainage volume and axillary drainage volume in the study group were lower than those in the control group(P<0.05).There was no statistically significant difference in FACT-B and BPI scores before surgery between the two groups(P>0.05).The change in FACT-B and BPI scores before and after surgery in the study group was greater than that in the control group(P<0.05).Compared with the control group,the study group had a lower incidence of flap necrosis,and the inci-dence of high-grade flap necrosis was lower than that in the control group(P<0.05).There was no statisti-cally significant difference in the incidence and severity of lymphedema between the two groups(P>0.05).There was no statistically significant difference in comfort scores between the two groups before surgery(P>0.05).Compared with the control group,the study group had higher comfort scores at 1 day,1 month,and 3 months after surgery(P<0.05).Conclusion:Double-tube negative pressure dr

关 键 词：双管接负压吸引器引流 传统胸带加压包扎法 乳房下脂肪筋膜瓣保乳整形术 术后引流量 皮瓣坏死率 

分 类 号：R737.9[医药卫生—肿瘤]