微创负压抽吸术联合完全性降压疗法治疗乳腺癌相关性淋巴水肿的疗效观察

目的:探讨微创负压抽吸术联合完全性降压疗法（CDT）对乳腺癌相关性淋巴水肿的临床效果。方法:通过我院医学伦理委员会批准，采用随机、双盲法进行对照研究，选取2014年9月至2016年9月在我院行乳腺癌改良根治术后引起相关性淋巴水肿的患者60例作为研究对象。随机分为两组，对照组30例常规CDT处理;治疗组30例，给予微创负压抽吸术联合CDT治疗。观察两组患者淋巴水肿缓解情况、水肿部位感染情况、肢体外形满意情况等指标。结果:治疗前后患肢周径变化通过统计学分析，治疗组与对照组相比有显著性差异（P＜0.05）;治疗后患肢疼痛消失时间治疗组与对照组相比差异有统计学意义（P＜0.05）；水肿部位感染率治疗组为6.7%，对照组为20.0%，治疗组感染率明显低于对照组，差异有统计学意义（P＜0.05）；治疗后肢体外形满意率对照组为40.0%，治疗组为63.3%，差异有统计学意义（P＜0.05）。结论:微创负压抽吸术联合CDT可明显改善乳腺癌术后相关性淋巴水肿程度，疗效肯定、方法易行，不会对患肢淋巴系统造成进一步破坏，具有一定临床推广价值。

Effective observation on minimal invasive and negative pressure aspiration with CDT for the lymphedema related to breast cancer

Objective:To investigate the clinical effect of minimal invasive and negative pressure aspiration with CDT for the lymphedema related to breast cancer.Methods:Approved by the medical ethics committee of our hospital,with a randomized and controlled study of double blind method,selected the 60 patients from September 2014 to September 2016 in our hospital that underwent lymphedema after modified radical mastectomy as the research object,divided them into two groups randomly,30 cases in the control group of conventional compele depressurize therapy(CDT) treatment. 30 cases in the treatment group were given minimal invasive and negative pressure aspiration with CDT treatment.Two groups were observed in patients with lymphedema to ease the situation,the infection of edema site,satisfaction of physical appearance and the index before and after treatment.Results:Circumference changes of limb through the statistical analysis,the treatment group had significant difference compared with the control group(P＜0.05).The time of limb pain disappeared of the treatment group and the control group had statistical difference(P＜0.05).Water swelling rate of treatment group was 6.7%.The infected rate of control group was 20.0%,the infected rate of treatment group was significantly lower than the control group,has a statistically significant difference(P＜0.05).The satisfied rate of limb appearance after the treatment was 40.0% in the control group,the treatment group was 63.3%,has a statistically significant difference(P＜0.05).Conclusion:Minimal invasive and negative pressure aspiration with CDT can improve the lymphedema related to breast cancer,has a certain effect on it and the methods is simple,will not cause further damage to the lymphatic system of the limb,has a certain clinical value.