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目的:探讨乳腺癌手术时上肢淋巴管显影结扎对减少皮下积液形成的临床意义。方法:选择2009年8月至2011年8月入住我院的172例乳腺癌改良根治术病人。分为研究组和对照组,每组各86例。研究组病人在手术时用0.25%亚甲蓝行上肢淋巴管显影,同时行显影淋巴管结扎;对照组病人常规手术不行淋巴管显影。统计分析两组病人的拔管时间和拔管后积液发生率。结果:两组病人一般情况无统计学差异,研究组平均拔管时间为术后(8.6±10.3)d;对照组为术后(11.5±12.3)d,两者比较有统计学差异﹙P<0.001)。研究组拔管后发生积液5例,发生率为5.8%;对照组13例,发生率为15.1%,有统计学差异(P<0.05)。结论:乳腺癌改良根治术行腋窝淋巴结清扫时,对上肢来源的淋巴管进行显影,并将断端予以结扎,可缩短拔管时间,减少皮下积液的发生率。
Objective: To investigate the clinical significance of ligation of upper limb lymphatic vessels during breast cancer surgery to reduce the formation of subcutaneous effusion. Methods: A total of 172 patients with modified radical mastectomy admitted to our hospital from August 2009 to August 2011 were selected. Divided into study group and control group, 86 cases in each group. The study group patients with 0.25% methylene blue at the time of surgery on the development of upper limb lymphatic vessels, at the same time the development of lymphatic ligation; patients in the control group routine lymphangiogenesis. Statistical analysis of two groups of patients extubation time and effusion after extubation. Results: There was no significant difference between the two groups in general. The average extubation time was 8.6 ± 10.3 days in the study group and 11.5 ± 12.3 days after the operation in the control group (P < 0.001). In the study group, effusion occurred after extubation in 5 cases, the incidence was 5.8%; control group, 13 cases, the incidence was 15.1%, with statistical significance (P <0.05). Conclusions: When axillary lymph node dissection is performed in modified radical mastectomy, the lymphatic vessels of upper extremity are developed and the ligature ends are ligated to shorten the extubation time and reduce the incidence of subcutaneous effusion.