| 徐方圆,吴瑞乔.皮瓣多点固定及多根 Y形管负压引流在乳腺癌改良根治术中的应用[J].安徽医药,2023,27(4):767-770. |
| 皮瓣多点固定及多根 Y形管负压引流在乳腺癌改良根治术中的应用 |
| Application of multi-point fixation of skin flaps and negative pressure drainage of multiple Y-shaped tubes in modified radical mastectomy |
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| DOI：10.3969/j.issn.1009-6469.2023.04.030 |
| 中文关键词: 乳房切除术，改良根治性 乳腺肿瘤 皮瓣固定 负压引流 皮瓣坏死 皮下积液 |
| 英文关键词: Mastectomy, modified radical Breast neoplasms Flap fixation Negative pressure drainage Subcutaneous fluid Flap necrosis |
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| 中文摘要: |
| 目的探讨皮瓣多点固定及多根 Y形管负压引流在乳腺癌改良根治术中的应用。方法选取武汉科技大学附属天佑医院甲乳外科 2017年 9月至 2020年 9月收治的 121例行乳腺癌改良根治术的病人为研究对象，其中试验组 61例采取皮瓣多点固定及多根 Y形引流管持续负压引流，术后无须加压包扎；对照组 60例采用直接间断缝合切口及胸骨旁和腋窝普通引流管持续负压引流，术后加压包扎。比较两种不同的处理方式出现皮下积液，皮瓣坏死，切口感染和上肢淋巴水肿等并发症的情况及对病人疼痛和舒适度的影响。结果术后并发症的比较中试验组皮下积液的发生率 4.92%(3/61)低于对照组 18.33%(11/60)，试验组皮瓣坏死的发生率 1.64%(1/61)低于对照组 13.33%(8/60)，差异有统计学意义( P<0.05)，切口感染和上肢淋巴水肿的比较差异无统计学意义( P>0.05)；试验组术后疼痛( 91.80%，56/61)及舒适度( 86.89%，53/61)的情况均优于对照组( 75%，45/60； |
| 英文摘要: |
| Objective To explore the application of multi-point fixation of skin flaps and negative pressure drainage of multiple Y-shaped tubes in modified radical mastectomy.Methods A total of 121 patients undergoing modified radical mastectomy who were admitted to the Department of Thoracic and Breast Surgery, Tian You Hospital of Wuhan University of Science and Technology from September 2017 to September 2020 were selected as the research objects. Among the 61 cases in the experimental group, multi-point fixation of skin flaps and continuous negative pressure drainage with multiple Y-shaped drainage tubes were used, and no compression bandage was required after surgery. The 60 cases in the control group were treated with direct intermittent suture incisions and continuousnegative pressure drainage with parasternal and axillary drainage tubes, followed by compression bandaging after the operation. Thecomplications of subcutaneous effusion, skin flap necrosis, incision infection and lymphedema of the upper limbs in two different treatment methods, and their effects on patients′ pain and comfort, were compared.Results In the comparison of postoperative complications, the incidence of subcutaneous fluid in the experimental group was 4.92% (3/61), lower than that of the control group 18.33% (11/60), and the incidence of flap necrosis in the experimental group was 1.64% (1/61), lower than that in the control group 13.33% (8/60),the difference was statistically significant (P<0.05). There was no statistically significant difference in incision infection and upper limb lymphedema (P >0.05). The postoperative pain (91.80%, 56/61) and comfort (86.89%, 53/61) of the experimental group were betterthan those of the control group (75%, 45/60; 66.67%, 40/60), the difference was statistically significant (All P<0.05). Conclusions Compared with traditional treatment methods, multi-point fixation of skin flaps and negative pressure drainage of multiple Y-shapedtubes can reduce the occurrence of subcutaneous fluid and skin flap necrosis. Meanwhile, patients have less postoperative pain andhigher comfort satisfaction. |
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