乳腺癌改良根治术中局部应用沙培林对减少皮下积液的疗效分析
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摘要
目的:分析乳腺癌改良根治术中局部应用沙培林对皮下积液的疗效。方法:选择2016年7月—2017年11月住院行乳腺癌改良根治术治疗的87例患者,随机分为观察组和对照组,观察组43例,对照组44例。观察组手术创面喷洒沙培林,对照组手术创面不使用沙培林。分析比较两组年龄、体质量、身体质量指数、体力状况(PS)评分、腋窝淋巴结转移数、肿瘤大小和病理分期;比较两组患者术后引流量和置管时间,同时观察患者是否有发热、切口疼痛、皮下积液、皮瓣坏死和皮瓣感染等术后并发症。结果:两组在年龄、体质量、体质量指数、体力状况评分、腋窝淋巴结转移数、肿瘤大小和病理分期方面比较,差异无统计学意义(P>0.05);观察组术后引流量低于对照组,引流管置管时间和住院天数短于对照组,发生皮下积液的患者人数明显少于对照组(P<0.01);两组患者术后发热、加疼痛、皮瓣坏死和感染等并发症发生率比较,差异无统计学意义(P>0.05)。结论:乳腺癌改良根治术中局部应用沙培林可有效减少引流量及引流管留置时间,预防皮下积液的发生。
Objective:To investigate the effectiveness of topical administration of sapylin in modified radical mastectomy on reducing subcutaneous effusion.Methods:From July 2016 to November 2017,a total of 87 patients receiving modified radical mastectomy were enrolled in this study.The patients were randomly divided into two groups.Forty-three patients in the experimental group were administrated sapylin in the surface of operative wounds,and 44 patients in the control group were not treated with sapylin.Comparison based on age,body weight,body mass index,physical condition score,axillary lymph node metastasis,tumor size and pathological stage between the experimental and the control group was conducted.Analysis based on postoperative drainage volume and drainage tube duration was performed between the experimental and the control group.We also observed postoperative complications including fever,incision pain,subcutaneous effusion,flap necrosis,and flap infection.Results:There was no significant difference based on the age,body weight,body mass index,physical condition score,axillary lymph node metastasis,tumor size,and pathological stage between the experimental group and the control group(P>0.05).The total postoperative drainage volume in the experimental group was less than that in the control group.The postoperative drainage tube duration and hospitalization duration were shorter in the experimental group compared to the control group.The number of patients suffering from subcutaneous hydrops was significantly lower than that in the control group(P<0.01).There was no significant difference base on postoperative complications including fever,incision pain,subcutaneous effusion,flap necrosis,and flap infection(P>0.05).Conclusion:Topical administration of sapylin in modified radical mastectomy for breast cancer can effectively reduce postoperative drainage volume,shorten drainage tube duration,and prevent subcutaneous hydrops.
Objective:To investigate the effectiveness of topical administration of sapylin in modified radical mastectomy on reducing subcutaneous effusion.Methods:From July 2016 to November 2017,a total of 87 patients receiving modified radical mastectomy were enrolled in this study.The patients were randomly divided into two groups.Forty-three patients in the experimental group were administrated sapylin in the surface of operative wounds,and 44 patients in the control group were not treated with sapylin.Comparison based on age,body weight,body mass index,physical condition score,axillary lymph node metastasis,tumor size and pathological stage between the experimental and the control group was conducted.Analysis based on postoperative drainage volume and drainage tube duration was performed between the experimental and the control group.We also observed postoperative complications including fever,incision pain,subcutaneous effusion,flap necrosis,and flap infection.Results:There was no significant difference based on the age,body weight,body mass index,physical condition score,axillary lymph node metastasis,tumor size,and pathological stage between the experimental group and the control group(P>0.05).The total postoperative drainage volume in the experimental group was less than that in the control group.The postoperative drainage tube duration and hospitalization duration were shorter in the experimental group compared to the control group.The number of patients suffering from subcutaneous hydrops was significantly lower than that in the control group(P<0.01).There was no significant difference base on postoperative complications including fever,incision pain,subcutaneous effusion,flap necrosis,and flap infection(P>0.05).Conclusion:Topical administration of sapylin in modified radical mastectomy for breast cancer can effectively reduce postoperative drainage volume,shorten drainage tube duration,and prevent subcutaneous hydrops.
引文
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[11]祖健,陈楚吟,胡美霞,等.术中应用A群链球菌制剂预防乳腺癌根治术后皮下积液的疗效观察[J].中国继续医学教育,2016,8(31):174-176.
[12]王秦西,马建瓴,张炯,等.短棒杆菌注射液在乳腺癌改良根治术后局部并发症防治中的临床研究[J].中国肿瘤外科杂志,2015,7(5):292-295.
[2]MATSEN C B,NEUMAYER L A.Breast cancer:a review for the general surgeon[J].JAMA Surg,2013,148(10):971-979.
[3]郝凯峰.乳腺癌改良根治术后皮下积液产生的高危因素及预防措施[J].实用癌症杂志,2018(4):686-689.
[4]龙鹏.沙培林在恶性胸腔积液治疗中的临床效果探析[J].临床医药文献电子杂志,2017,4(23):4395.
[5]武建.乳腺癌根治术后皮下积液的防治[J].临床医学,2014(2):64-65.
[6]陈安杰,王鹤令,姚旭,等.双引流管负压吸引在乳腺癌术后的应用[J].现代肿瘤医学,2012,20(11):2291-2292.
[7]张颖,代引海,邱春丽,等.皮瓣种豆联合皮下放置中人氟安对减少乳腺癌术后引流量的疗效分析[J].现代肿瘤医学,2018(10):1548-1550.
[8]ZHAO J,SU F,HU Y,et al.Prospective comparison of sapylin and avitene for reducing hydrops after axillary lymphadenectomy in breast cancer patients[J].J Surg Res,2017,210:8-14.
[9]DONKER M,HAGE J J,WOERDEMAN L A,et al.Surgical complications of skin sparing mastectomy and immediate prosthetic reconstruction after neoadjuvant chemotherapy for invasive breast cancer[J].Eur J Surg Oncol,2012,38(1):25-30.
[10]胡敏超.乳腺癌根治术中局部应用沙培林对腋窝积液的疗效观察[J].山东医药,2013,53(17):58-59.
[11]祖健,陈楚吟,胡美霞,等.术中应用A群链球菌制剂预防乳腺癌根治术后皮下积液的疗效观察[J].中国继续医学教育,2016,8(31):174-176.
[12]王秦西,马建瓴,张炯,等.短棒杆菌注射液在乳腺癌改良根治术后局部并发症防治中的临床研究[J].中国肿瘤外科杂志,2015,7(5):292-295.