摘要
目的观察乳腺癌改良根治术或单乳切除术后皮瓣坏死早期清创缝合的临床效果,探讨该方法的临床意义。方法选取天津市中心妇产科医院乳腺科201 1年1月至2014年1月间乳癌术后发生皮瓣坏死病例39例,其中25例对坏死皮瓣进行早期清创缝合(治疗组),14例进行传统外科换药(对照组),观察比较两组皮瓣愈合时间和3周内的皮瓣愈合率。结果治疗组1度、Ⅱ度、Ⅲ度及总的愈合时间均显著短于对照组,差异有统计学意义(U值分别为4.201、5.573、4.894、8.674,均P<0.05)。治疗组总的3周愈合率为92.00%,显著高于对照组的57.10%,差异有统计学意义(x^2=11.291,P<0.05),且治疗组Ⅰ度、Ⅱ度3周愈合率均高于对照组,差异均有统计学意义(x^2值分别为8.912、8.542,均P<0.05)。结论应用皮瓣坏死早期清创缝合的方法较传统换药方法可缩短乳癌患者术后切口愈合时间,提高愈合率,具有较高的临床应用价值。
Objective To observe the clinical effect of debridement on flap necrosis after modified radical mastectomy or single mastectomy and to explore the clinical significance of the method. Methods Thirty-nine cases of flap necrosis after mastectomy treated during January 2011 to January 2014 in Tianjin Central Obstetrics and Gynecology Hospital were chosen, including 25 cases with early debridement （treatment group） and 14 cases with surgical treatment （control group）. The flap healing time and healing rate within 3 weeks were compared between two groups. Results The overall healing time and healing time of I ,Ⅱ and Ⅲ degree in the treatment group were shorter than those of the control group with significant differences （ U value was 4. 201, 5. 573, 4. 894 and 8. 674, respectively, all P 〈 0.05 ）. The total healing rate within 3 weeks in the treatment group was 92.00% , which was obviously higher than that in the control group （57.10%） （X2 = 11. 291,P 〈 0.05 ）, and the healing rate of Ⅰ and Ⅱ degree within 3 weeks was also significantly higher （X2 value was 8. 912 and 8. 542, respectively, both P 〈 0.05）. Conclusion Compared with traditional treatment method, early debridement can shorten healing time and improve healing rate with high clinical value.
出处
《中国妇幼健康研究》
2015年第6期1305-1306,1328,共3页
Chinese Journal of Woman and Child Health Research
关键词
乳腺癌
皮瓣坏死
清创缝合
愈合
breast cancer
flap necrosis
debridement
healing
