乳腺癌术后皮下积液产生的原因及其对皮瓣坏死的影响

目的:探讨乳腺癌术后皮下积液产生的原因及其对皮瓣坏死的影响。方法:对138例乳腺癌的临床资料进行回顾性分析,123例行乳腺癌标准根治术,13例行乳腺癌改良根治术,2例行保乳根治术。结果:34例皮下积液(24.6%),其中皮瓣坏死12例(35.3%);无皮下积液104例(75.4%),其中皮瓣坏死12例(11.5%),有皮下积液者皮瓣坏死率明显高于无皮下积液者(P<0.05)。结论:乳腺癌术后皮下积液是导致皮瓣坏死的主要原因之一。预防淋巴管瘘、合理应用电刀、术后皮下放置引流管充分引流及合理的胸带包扎可以减少皮下积液的产生,从而减少皮瓣的坏死。

Causes of postoperative subcutaneous liquid accumulation in patients with breast cancer and its affection to skin flap necrosis

Objective: To explore the relations of subcutaneous liquid accumulation and skin flap necrosis after modified radical mastectomy. Methods: A retrospective analysis of the accumulative liquid of subcuta-nea and skin flap necrosis of 34 cases of postoperative of breast cancer among 138 patients from January 1985 to January 2004. Results: Subcutaneous liquid accumulation occurred in 34 patients and skin flap necrosis in 24. The incidence of the flap necrosis of the accumulative liquid group was higher than that without accumulative liquid group. There was significant difference between the two groups (P <0. 05). Conclusions: Accumulative liquid of subcutaneous is one of the important cause leading to the skin flap necrosis after operation of breast cancer, and we can use proper ways to prevent and decrease its production. To prevent lymphatic fistula, reasonable use of electrotome, postoperative deposited duct, appropriate chest band enswathing can decrease the production of accumulative liquid of subcutaneous and the skin flap necrosis.