乳腺癌术后皮下积液长期存在相关问题的探讨

目的：探讨乳腺癌术后皮下积液形成及长期存在的原因。方法对乳腺癌术后皮下积液形成的纤维板障进行病理形态学分析；抽取乳腺癌术后不同时段引流液体行成分分析；为了解纤维板障形成过程，建立皮下积液动物模型，对不同时段形成的纤维板障进行病理学分析。结果人纤维板障病理学分析显示分为纤维渗出层、毛细血管层及纤维层三层结构；血液学检验结果支持乳腺癌术后皮下积液为渗出液；动物模型显示，随积液时间延长，纤维板障结构逐渐增厚。结论纤维板障中的毛细血管的存在是皮下积液长期存在的组织学基础，切除或破坏皮下纤维板障，使创面重新开始愈合过程是尽早解决乳腺癌术后皮下积液长期存在的一种有效的方法。

The reasons of long-term existence of seroma after modified radical mastectomy

Objective To study the reasons of seroma formation and long-term existence after modified radi-cal mastectomy （ MRM） .Methods The structure of fibrous lamina for seroma postoperative breast cancer was ana-lyzed by pathological methods;the composition of drainage fluids after MRM in the different postoperative time peri-ods was determined;and the structure of fibrous lamina following an experimental mastectomy model created in rats was investigated,which the process of fibrous lamina formation was imitated.Results There were three layer struc-tures in fibrous lamina,including fibrous leakage,capillaries and fiber lay.Hematology test results supported seroma for exudate.Animal model showed that with the extension of time,fibrous lamina thickened gradually.Conclusion It is capillaries in fibrous lamina that seroma long-standing histological basis.Maybe excising or destructing the structure of subcutaneous fibrous lamina,making the procedure of wound healing to begin again as soon as possible,which is a kind of effective method to solve the problem of seroma long-term existence after MRM.