乳腺癌改良根治术后皮瓣坏死的危险因素分析  

Risk Factors for Skin Flap Necrosis after Modified Radical Surgery for Breast Cancer

作　　者：李慧[1] 赵雪 马晓鑫 LI Hui;ZHAO Xue;MA Xiaoxin(Department of Gynecologic Breast Surgery,The First Affiliated Hospital of Henan University of Science and Technology,Luoyang,Henan 471000,China)

机构地区：[1]河南科技大学第一附属医院妇科乳腺外科,河南洛阳471000

出　　处：《中国烧伤创疡杂志》2024年第3期210-213,共4页The Chinese Journal of Burns Wounds & Surface Ulcers

摘　　要：目的分析探讨乳腺癌改良根治术后皮瓣坏死的危险因素。方法选取2021年1月至2022年2月河南科技大学第一附属医院收治的92例拟行乳腺癌改良根治术治疗的乳腺癌患者作为研究对象,收集患者年龄、乳腺癌分期、病灶部位、肿瘤长径、病理分型、皮瓣厚度、皮瓣张力、包扎压力、是否合并糖尿病、术后是否发生皮瓣坏死等临床资料,并依据术后皮瓣坏死发生情况将其分为正常组与坏死组,多因素Logistic回归分析乳腺癌改良根治术后皮瓣坏死的危险因素。结果92例乳腺癌患者中乳腺癌改良根治术后出现皮瓣坏死30例(3261%),设为坏死组;未出现皮瓣坏死62例(6739%),设为正常组。单因素分析结果显示,坏死组皮瓣薄、皮瓣张力高、包扎过紧、合并糖尿病的患者比例均明显高于正常组(χ^(2)=6550、6753、6418、6332,P=0010、0009、0011、0012);多因素Logistic回归分析结果显示,皮瓣薄、皮瓣张力高、包扎过紧以及合并糖尿病是乳腺癌改良根治术后皮瓣坏死的独立危险因素(95%CI为1313~4533、1059~2640、1124~4277、1180~3899,P=0005、0028、0022、0013)。结论皮瓣薄、皮瓣张力高、包扎过紧以及合并糖尿病是乳腺癌改良根治术后皮瓣坏死的独立危险因素。Objective To analyze the risk factors for skin flap necrosis after modified radical surgery for breast cancer.Methods 92 patients with breast cancer,admitted to The First Affiliated Hospital of Henan University of Science and Technology for modified radical surgery from January 2021 to February 2022,were selected as research subjects,and their clinical data were collected including age,staging of breast cancer,focus site,tumor long diameter,pathological type,skin flap thickness,skin flap tension,bandaging pressure,complicated with diabetes or not,and whether there was occur-rence of skin flap necrosis after surgery.The patients were divided into the normal group and the necrosis group based on whether skin flap necrosis ever occurred after surgery,and multivariate Logistic regression analysis was conducted to analyze the risk factors for skin flap necrosis after modified radical surgery for breast cancer.Results Among the 92 patients with breast cancer,30 cases(3261%)developed skin flap necrosis after modified radical surgery,being set as the necrosis group,and the other 62 cases(6739%)did not develop skin flap necrosis,being set as the normal group.The results of univariate analysis showed that the proportions of patients with thin skin flap,high skin flap tension,excessive bandaging pressure,and complicated with diabetes were significantly higher in the necrosis group compared with the normal group(χ^(2)=6550,6753,6418 and 6332,P=0010,0009,0011 and 0012).Multivariate Logistic regression analysis showed that thin skin flap,high skin flap tension,excessive bandaging pressure,and complicated with diabetes were inde-pendent risk factors for skin flap necrosis after modified radical surgery for breast cancer(95%CI:1313-4533,1059-2640,1124-4277,1180-3899,P=0005,0028,0022 and 0013).Conclusion Thin skin flap,high skin flap tension,excessive bandaging pressure and complicated with diabetes were independent risk factors for skin flap necrosis after modified radical surgery for breast cancer.

关 键 词：乳腺癌 改良根治术 皮瓣坏死 危险因素 加压包扎 皮瓣厚度 皮瓣张力 

分 类 号：R737.9[医药卫生—肿瘤]