乳腺癌术中淋巴管显影结扎减少皮下积液的应用

目的:探讨乳腺癌手术时上肢淋巴管显影结扎对减少皮下积液形成的临床意义。方法:选择2009年8月至2011年8月入住我院的172例乳腺癌改良根治术病人。分为研究组和对照组,每组各86例。研究组病人在手术时用0.25%亚甲蓝行上肢淋巴管显影,同时行显影淋巴管结扎;对照组病人常规手术不行淋巴管显影。统计分析两组病人的拔管时间和拔管后积液发生率。结果:两组病人一般情况无统计学差异,研究组平均拔管时间为术后(8.6±10.3)d;对照组为术后(11.5±12.3)d,两者比较有统计学差异﹙P0.001)。研究组拔管后发生积液5例,发生率为5.8%;对照组13例,发生率为15.1%,有统计学差异(P0.05)。结论:乳腺癌改良根治术行腋窝淋巴结清扫时,对上肢来源的淋巴管进行显影,并将断端予以结扎,可缩短拔管时间,减少皮下积液的发生率。

Reducing seroma formation after staining and ligation of lymphatic channels during breast cancer operation

Objective To investigate the effect of staining and ligation of lymphatic channels on the reduction ot seroma formation during breast cancer operation. Methods One hundred seventy-two patients with breast cancer underwent modified radical mastectomy from August 2009 to August 2011 were investigated. The patients were divided into two groups with 86 cases in each group. In the study group, lymphatic channels of upper limb were stained with methylene blue stain and ligated. Conventional operations were applied in the control group. Extubation time and the rate of seroma formation after extubation were compared. Results The mean extubation time was （8.6±10.3） days after operations in the study group and （11.5±12.3） days in the control group. The difference was statistically significant, P〈 0.001. The rate of seroma formation after extubation was 5.8%（5/86） in study group, which was significantly lower than that in the control group （15.1%,13/86）, P〈0.001. Conclusions Staining and ligation of lymphtaic channels of upper limb in modified radical mastectomy of breast cancer could shorten drainage time and reduce the rate of seroma formation.