高负压、低负压以及零负压引流对宫颈癌手术患者预后的影响
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摘要
目的研究高负压、低负压以及零负压引流对宫颈癌手术患者预后的影响。方法选择进行手术治疗的65例宫颈癌患者,随机分为3组。对3组患者的手术切口均采取自然对合处理,A组患者未进行负压引流,B组患者采取低负压引流,C组患者采取高负压引流。比较3组患者引流管留置时间、术后1 d和术后3 d的切口渗液引流量、平均换药次数、平均拆线时间以及平均住院时间,比较3组患者术后1 d和术后3 d引流液中的转化生长因子-β(TGF-β)以及血小板衍生因子(PDGF)水平。结果 B组和C组的引流管留置时间和术后3 d的切口渗液引流量均明显低于A组(P <0. 05),且C组明显低于B组(P <0. 05)。3组的平均换药次数以及平均住院时间相比无明显的差异(P> 0. 05); B组和C组的平均拆线时间明显短于A组(P <0. 05),且C组明显短于B组(P <0. 05)。B组和C组术后3 d引流液中TGF-β、PDGF水平均明显高于A组(P <0. 05),且C组明显高于B组(P <0. 05)。结论与低负压以及零负压相比,高负压引流更有助于促进宫颈癌患者手术切口的愈合,值得应用推广。
Objective To study the effect of high negative pressure,low negative pressure and zero negative pressure drainage on the prognosis of patients with cervical cancer surgery. Methods Selected 65 cases of patients with cervical cancer divided into three groups randomly. Patients in group A were not treated with negative pressure drainage,while those in group B were treated with low negative pressure drainage. C group was treated with high negative pressure drainage. The retention time of drainage tube between two groups were compared. Incision drainage volume,mean dressing frequency,average suture removal time,and average length of stay after 1 d and 3 d after operation between two groups were compared. The levels of transforming growth factor-β( TGF-β) and platelet-derived factor( PDGF) in drainage fluids were compared between the first and third postoperative days in the 3 groups. Results In group B and group C,the drainage tube retention time and incision leakage and drainage volume at third d after operation were significantly lower than those in group A( P < 0. 05),and C group was significantly lower than B group( P < 0. 05). There was no significant difference in the average change times and the average hospitalization time( P > 0. 05). The average breaking time of the B and C groups was significantly shorter than A group( P < 0. 05),and the C group was significantly shorter than that in the B group( P < 0. 05). In group B and group C,the levels of TGF-β and PDGF in drainage fluid third d after operation were significantly higher than those in A group( P < 0. 05),and C group was significantly higher than that in B group( P < 0. 05). Conclusion Compared with low negative pressure and zero negative pressure,high negative pressure drainage is more conducive to the healing of surgical incision of cervical cancer patients,which is worthy of application and promotion.
Objective To study the effect of high negative pressure,low negative pressure and zero negative pressure drainage on the prognosis of patients with cervical cancer surgery. Methods Selected 65 cases of patients with cervical cancer divided into three groups randomly. Patients in group A were not treated with negative pressure drainage,while those in group B were treated with low negative pressure drainage. C group was treated with high negative pressure drainage. The retention time of drainage tube between two groups were compared. Incision drainage volume,mean dressing frequency,average suture removal time,and average length of stay after 1 d and 3 d after operation between two groups were compared. The levels of transforming growth factor-β( TGF-β) and platelet-derived factor( PDGF) in drainage fluids were compared between the first and third postoperative days in the 3 groups. Results In group B and group C,the drainage tube retention time and incision leakage and drainage volume at third d after operation were significantly lower than those in group A( P < 0. 05),and C group was significantly lower than B group( P < 0. 05). There was no significant difference in the average change times and the average hospitalization time( P > 0. 05). The average breaking time of the B and C groups was significantly shorter than A group( P < 0. 05),and the C group was significantly shorter than that in the B group( P < 0. 05). In group B and group C,the levels of TGF-β and PDGF in drainage fluid third d after operation were significantly higher than those in A group( P < 0. 05),and C group was significantly higher than that in B group( P < 0. 05). Conclusion Compared with low negative pressure and zero negative pressure,high negative pressure drainage is more conducive to the healing of surgical incision of cervical cancer patients,which is worthy of application and promotion.
引文
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[10]廖雄,汤敬武,邓俭良.封闭负压引流技术在四肢皮肤缺损合并感染治疗中的应用[J].中国现代手术学杂志,2017,21(2):145-148.
[11]王立民,郑文立,张向涛.创面封闭负压引流技术对肌腱外露创面治疗作用的临床分析[J].河北医药,2016,38(6):848-850.
[12]涂奎,赵礼金.TGF-β及PDGF介导的信号通路在肝纤维化中的作用[J].重庆医学,2015,44(4):551-553.
[2]吴翠霞,张艳红,葛小花,等.高危型HPV感染与宫颈癌前病变与宫颈癌的相关性研究[J].中华医院感染学杂志,2016,26(11):2568-2570.
[3]Sun R,Qin C,Jiang B,et al.Down-regulation of MALAT1inhibits cervical cancer cell invasion and metastasis by inhibition of epithelial-mesenchymal transition[J].Molecular Biosystems,2016,12(3):952-962.
[4]刘飞,曲振玲,郭正东,等.封闭式负压引流技术在各种复杂创面治疗中的应用[J].海南医学,2016,27(1):49-52.
[5]彭俊,黄勇.90例年轻宫颈癌患者临床特征及术后复发和预后相关因素分析[J].实用妇产科杂志,2016,32(1):42-45.
[6]杨丽玲,陈俊,张翔珍.妇科门诊患者对宫颈癌知识的认知程度及其对宫颈癌检出率的影响[J].中国性科学,2016,25(5):26-28.
[7]周晖,林仲秋.美国国立综合癌症网络“2016宫颈癌临床实践指南”解读[J].中国实用妇科与产科杂志,2016,32(3):223-230.
[8]张昕蕾,张军,蔡有芹,等.腹腔镜手术治疗108例宫颈癌的临床分析[J].中国微创外科杂志,2016,16(11):980-982.
[9]王康,秦涛,吴海卫,等.封闭式负压引流技术治疗兔胸部开放性伤口的效果[J].山西医科大学学报,2017,48(2):132-135.
[10]廖雄,汤敬武,邓俭良.封闭负压引流技术在四肢皮肤缺损合并感染治疗中的应用[J].中国现代手术学杂志,2017,21(2):145-148.
[11]王立民,郑文立,张向涛.创面封闭负压引流技术对肌腱外露创面治疗作用的临床分析[J].河北医药,2016,38(6):848-850.
[12]涂奎,赵礼金.TGF-β及PDGF介导的信号通路在肝纤维化中的作用[J].重庆医学,2015,44(4):551-553.