罗哌卡因与左旋布比卡因治疗乳腺癌根治术后创面积液临床分析

目的探讨罗哌卡因与左旋布比卡因治疗乳腺癌根治术后创面积液的临床效果。方法将2007年1月～2010年6月我院经过乳腺癌根治术治疗并在手术后有创面积液的患者99例按照治疗的先后顺序随机分为三组，Ⅰ组患者31例，不给予神经阻滞，Ⅱ组患者34例，给予罗哌卡因进行神经阻滞，Ⅲ组患者34例，给予左旋布比卡因进行神经阻滞，比较三组患者术后第5天、第10天的引流液量、患者创面愈合情况及患者拔除引流管的时间。结果Ⅱ组患者和Ⅲ组患者术后引流液体量均小于Ⅰ组患者（P〈0．05）；术后第5天，Ⅰ组患者拔管8例，Ⅱ组患者拔管20例，Ⅲ组患者拔管19例；第10天，Ⅰ组拔管16例，Ⅱ组拔管32例，Ⅲ组拔管33例，Ⅱ组和Ⅲ组患者明显优于Ⅰ组患者（P〈0．05）；Ⅲ组患者和Ⅱ组患者术后创面愈合情况优于Ⅰ组患者（P〈0．05）。结论采用罗哌卡因与左旋布比卡因治疗乳腺癌根治术后创面积液具有较好的疗效，患者术后创面愈合较好，可早期拔管，值得在临床推广使用。

Effect of Ropivacaine and Levobupivacaine in Treatment of Wound Fluid after Radical Mastectomy: A Clinical Analysis

Objective To investigate the effect of ropivacaine and levobupivacaine in treatment of wound fluid after radical mastectomy. Methods There were 99 cases treated after radical mastectomy and wound fluid after surgery from January 2007 to June 2010 in our hospital. According to the order they were randomly divided into three groups, Ⅰ group of patients （ 31 cases ） does not given nerve block, Ⅱ patients （ 34 cases ） be given ropivacaine nerve block, Ⅲ patients （ 34 cases ） given levobupivacaine for nerve block, compared three groups of patients after 5 days , 10 days of drainage, the patient and wound healing time in patients with drainage tubes were removed. Results The patients with postoperative drainage fluid were less in Group Ⅱ and Group In than group Ⅰ patients, （P 〈 0.05 ） ; 5 days after surgery, Ⅰ extubation eight cases of patients, Ⅲ patients extubation 20 cases, Ⅲ patients pull tube in 19 cases; day 10, Ⅰ group 16 cases extubation,Ⅱ group of pulling 32 cases, Ⅲ group extubation 34 cases, Ⅱ and Ⅲ group as group Ⅰ patients were significantly （ P 〈 0.05 ） ; Ⅲ and Ⅱ patients group of patients with postoperative wound healing was better than group Ⅰ patients （ P 〈 0.05 ）. Conclusion Ropivacaine and levobupivacaine treatment after radical masteetomy wound fluid with good effect, good postoperative wound healing, and early extubation, it is in clinical use.