乳腺癌根治术后单纯负压引流与负压引流联合胸带加压包扎的效果比较

目的比较单纯负压引流与负压引流联合胸带加压包扎两种方法在预防乳腺癌术后皮下积液、皮瓣坏死以及患者舒适度方面的差异。方法收集2010年1月至2012年12月期间我院收治的196例乳腺癌根治手术病例，术后采用腋窝及胸壁放置双管负压引流并加用多头胸带加压包扎（简称“负压引流联合胸带加压组”，n=112）和仅腋窝及胸壁单纯放置双管负压引流（简称“单纯负压引流组”，n=84）2种不同方式预防术后皮下积液发生，通过对比其术后并发症、术后3d引流量、患者舒适度等相关因素，综合评估两种方法的效果。结果本组196例乳腺癌根治手术患者均为女性。2组患者的一般临床资料比较差异均无统计学意义（P〉0．05），具有可比性。单纯负压引流组和负压引流联合胸带加压组的胸壁拔管中位时间（7．00d比7．00d，P=O．053）、腋窝拔管中位时间（15．00d比16．00d，P=-O．080）、术后3d中位引流量（368mL比365mL，P=O．080）及皮下积液发生率（19．1％（16／84）比17．8％（20／112），P=O．922]和皮瓣坏死发生率2．4％（2／84）比5．4％（6／112），P-O．498]比较差异均无统计学意义，但单纯负压引流组患者术后舒适度满意率明显高于负压引流联合胸带加压组76．2％（16／84）比22．3％（25／112），P〈0．001]。2组患者均未影响术后放化疗。结论与负压引流联合胸带加压包扎相比，单纯负压引流在没有增加乳腺癌根治术后皮下积液、皮瓣坏死等并发症发生率的情况下，大大提高了患者术后舒适满意度。

Comparison of Efficacy Study of Simple Negative Pressure Drainage and It Combined with Chest CompressionBandaging after Radical Mastectomy for Breast Cancer

Objective To compare the differences in preventing subcutaneous effusion, skin flap necrosis, and patient comfort between simple negative pressure drainage and negative pressure drainage combined with chest compression bandaging after radical mastectomy for breast cancer. Methods One hundred and ninety-six patients underwent radical mastectomy for breast cancer from January 2010 to December 2012 in this hospital were collected. The simple negative pressure drainage （SNPD group, n=84） and negative pressure drainage combined with chest compression bandaging （NPD ＋ CB group, n- 112） after radical mastectomy for breast cancer were used to prevent postoperative subcutaneous effusion. The postoperative complications, postoperative 3 d drainage volume, and patient comfort were compared in two groups. Results One hundred and ninety-six patients with breast cancer were females. The differences of general clinical data were not statistically significant in two groups （P〉0. 05）. The differences of chest wall mean extubation time, axillary mean extubation time, postoperative 3 d mean drainage volume, and incidences of subcutaneous effusion and skin flap necrosis were not statistically significant in two groups （P〉 0.05）. The rate of comfort satisfactory in the SNPD group was significantly higher than that in the NPD ＋ CB group 176. 2% （16/84） versus 22. 3% （25/112）, P〈0. 0011. The chemotherapy was not affected after operation in two groups. Conclusions Comparing with negative pressuredrainage combined with chest compression bandaging, simple negative pressure drainage do not increase postoperative subcutaneous effusion and skin flap necrosis, but it greatly improves the patients satisfactory rate.