目的 探索高负压引流系统在乳腺癌改良根治术中的应用。方法 选择2013-01至2015-12行乳腺癌改良根治术的64例(女性),随机分为观察组和对照组,每组32例。观察组应用伤口高负压引流系统及附件引流,外用康复新液换药;对照组将2条多侧孔橡胶引流管置于肋弓及腋窝处接普通负压吸引罐引流,常规换药。观察两组的切口引流情况、并发症情况、切口愈合情况及相关费用。结果 观察组24 h内平均引流量为(111.09±16.78)ml,多于对照组的(103.13±9.16)ml;观察组的总引流量为(215.78±44.55)ml,少于对照组的(236.72±35.61)ml,观察组与对照组引流情况相比,差异有统计学意义(P<0.05);观察组术后并发症少于对照组,差异有统计学意义(P<0.05);两组皮瓣坏死程度差异无统计学意义(Z＝-0.062,P＝0.951);观察组拆线时间、换药次数、切口愈合等级与对照组相比,差异均有统计学意义(P<0.05)。结论 采用康复新液配合高负压引流系统在乳腺癌改良根治术中的应用效果较好,并发症明显减少,病程缩短,未明显增加费用,是一种有效的乳腺癌术后引流方法。
Abstract
Objective To explore the applicability of a drainage system in breast cancer patients after operation.Methods A total of 64 female patients with breast cancer who had undergone radical mastectomy between January 2013 and December 2015 were evenly divided into two groups. A high negative pressure drainage system and Kangfuxin liquid were used in 32 patients from the treatment group, while their counterparts from the control group had two multi-lateral perforated rubber drainage tubes attached to the normal negative pressure suction tank placed in the costal arch and axillary area, and received conventional dressing. Then, the drainage volume, incidence of complications, healing time of the incisions and related cost in both groups were recorded.Results Compared with the control group, the treatment group had a higher 24 h drainage volume[(111.09±16.78) ml versus (103.13±9.16) ml], but a lower total volume[(215.78±44.55)ml versus (236.72±35.61) ml], and earlier extubation [(5.25±1.16)d versus (5.97±1.23) d]. The difference was statistically significant. Also, the treatment group had fewer complications with a significantly statistical difference. There was no significant difference between the two groups in terms of the degree of skin flap necrosis (Z＝-0.062,P＝0.951). The difference of the time for stitches removal, number of times dressing was changed as well as incision healing levels between the two groups was statistically significant (P<0.05).Conclusions Kangfuxin liquid used together with a high negative pressure drainage system in cancer patients after modified radical mastectomy can dramatically reduce the incidence of complications, avoid unnecessary pain-causing procedures, shorten the course of disease, alleviate the pressure for both physicians and nurses, and reduce potential medical disputes without increasing the related cost, so it is an effective regimen for post-surgery patients with breast cancer.
关键词
乳腺癌 /
留置引流 /
康复
Key words
breast cancer /
indwelling drainage /
rehabilitation
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参考文献
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基金
河北省医学科学研究重点课题计划(20160818)
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