荷包缝合方法在乳腺癌改良根治术切口缝合中的应用

发布时间：2018-03-08 09:04

本文选题：荷包缝合　切入点：皮内缝合　出处：《广西医科大学》2016年硕士论文　论文类型：学位论文

【摘要】：目的：20世纪50年代以来,乳腺癌改良根治术在乳腺癌治疗中广泛应用,目前比较常用的切口缝合方法为直接行皮内缝合。而荷包缝合方法广泛应用于普外科手术治疗中,可收缩切口,减少术后出血。所以我们比较了乳腺癌改良根治术中切口行荷包缝合与直接皮内缝合治疗效果和切口愈合情况,来探讨荷包缝合方法应用于乳腺癌改良根治术切口缝合的可行性。方法：回顾性分析自2015年7月至2016年3月我院136名乳腺癌患者资料,均行乳腺癌改良根治术,根据切口缝合方法分为两组,其中荷包缝合组62例,直接皮内缝合组74例,对比两组患者的手术时间、术中出血量、术中清扫淋巴结个数、术后引流量、引流置管时间及术后出现皮下积液、皮瓣坏死的发生率。结果：手术时间,荷包缝合组(156.69±47.42)min与直接皮内缝合组(164.47±55.44)min对比,P=0.386。术中出血量,荷包缝合组(132.95±95.71)ml与直接皮内缝合组(51.96±45.74)ml对比, P0.001。术中清扫淋巴结个数,荷包缝合组(17.50±5.39)个与直接皮内缝合组(16.44±5.03)个对比,P=0.413。术后引流量,荷包缝合组(56.10±52.37)ml与直接皮内缝合组(202.45±166.05)ml对比,P0.001。引流置管时间,荷包缝合组(2.92±0.93)d与直接皮内缝合组(5.41±1.78)d对比,P0.001。皮下积液,荷包缝合组16/62(25.80%)与直接皮内缝合组12/74(16.21%)对比,P=0.168。皮瓣坏死,荷包缝合组5/62(8.06%)与直接皮内缝合组8/74(10.81%)对比,P=0.587。结论：乳腺癌在改良根治术的基础上,切口行荷包缝合缝合方法术后引流量较少、引流置管时间较短,术后并发症差异无统计意义,所以该手术切口缝合方法可在一定范围内进行推广。
[Abstract]:Objective since 50s of the 20th century, modified radical mastectomy has been widely used in the treatment of breast cancer. So we compared the effect of pocket suture with direct intradermal suture and wound healing in modified radical mastectomy for breast cancer. Methods: from July 2015 to March 2016, 136 patients with breast cancer in our hospital were retrospectively analyzed. According to the method of incision suture, the patients were divided into two groups: the purse suture group (n = 62) and the direct intradermal suture group (n = 74). The operative time, the amount of blood lost during operation, the number of lymph nodes dissected and the drainage volume after operation were compared between the two groups. Results: the operative time, the time of drainage and catheter insertion and the incidence of subcutaneous effusion and skin flap necrosis after operation were 156.69 卤47.42 minutes in the pocket suture group and 164.47 卤55.44 minutes in the direct intradermal suture group. Compared with the direct intradermal suture group (51.96 卤45.74ml), the number of lymph nodes dissected during operation was 17.50 卤5.39 in the purse suture group and 16.44 卤5.03 in the direct intradermal suture group. 56.10 卤52.37ml in the purse suture group and 202.45 卤166.05ml in the direct intradermal suture group compared with the direct intradermal suture group (P 0.001). The drainage time was 2.92 卤0.93d in the purse suture group and 5.41 卤1.78g / d in the direct intradermal suture group compared with that in the direct intradermal suture group (P 0.001). Conclusion: on the basis of modified radical mastectomy, the drainage flow of breast cancer is less, the drainage time is shorter, and there is no statistical significance in postoperative complications, on the basis of modified radical mastectomy, the drainage time is shorter, and the drainage time is shorter than that in the direct intradermal suture group (P < 0.05), conclusion: on the basis of modified radical mastectomy, the drainage time is shorter than that in the direct intradermal suture group, and there is no statistical significance between the two groups. Therefore, the surgical incision suture method can be extended to a certain extent.
【学位授予单位】：广西医科大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R737.9

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