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中华普通外科学文献(电子版) ›› 2020, Vol. 14 ›› Issue (01) : 23 -26. doi: 10.3877/cma.j.issn.1674-0793.2020.01.007

所属专题: 文献

论著

乳腺癌改良根治术中局部应用碘酊对减少皮下积液的效果分析
侯栋1, 薛会朝1,(), 李建1   
  1. 1. 453100 新乡医学院第一附属医院普外科
  • 收稿日期:2019-11-07 出版日期:2020-02-01
  • 通信作者: 薛会朝
  • 基金资助:
    河南省科技厅科技攻关项目(172102310405)

Efficacy of topical administration of iodine tincture in modified radical mastectomy on reducing subcutaneous hydrops

Dong Hou1, Huichao Xue1,(), Jian Li1   

  1. 1. Department of General Surgery, the First Affiliated Hospital of Xinxiang Medical University, Xinxiang 453100, China
  • Received:2019-11-07 Published:2020-02-01
  • Corresponding author: Huichao Xue
  • About author:
    Corresponding author: Xue Huichao, Email:
引用本文:

侯栋, 薛会朝, 李建. 乳腺癌改良根治术中局部应用碘酊对减少皮下积液的效果分析[J/OL]. 中华普通外科学文献(电子版), 2020, 14(01): 23-26.

Dong Hou, Huichao Xue, Jian Li. Efficacy of topical administration of iodine tincture in modified radical mastectomy on reducing subcutaneous hydrops[J/OL]. Chinese Archives of General Surgery(Electronic Edition), 2020, 14(01): 23-26.

目的

探讨乳腺癌改良根治术中局部应用质量浓度2%碘酊对减少皮下积液的效果。

方法

前瞻性选择2018年5月至2019年3月新乡医学院第一附属医院行乳腺癌改良根治术的81例患者为研究对象,按随机数字法分为观察组(41例)和对照组(40例)。观察组手术创面喷洒5 ml质量浓度2%碘酊,对照组手术创面喷洒5 ml 0.9%氯化钠溶液。比较两组患者术后第1天、第2天和第3天引流管引流量、留置时间,住院时间,皮下积液、皮瓣坏死等术后并发症的发生率。

结果

两组患者在年龄、体质指数、职业和学历方面比较,差异无统计学意义。观察组术后第1天、第2天、第3天引流管引流量均低于对照组,引流管留置时间和住院时间短于对照组,差异均有统计学意义(t=3.348、4.421、2.966、5.936、10.070,P=0.001、<0.001、0.004、<0.001、<0.001)。观察组术后皮瓣坏死发生率为7.3%(3/41),对照组为5.0%(2/40),差异无统计学意义(χ2=0.240,P=0.624)。观察组术后皮下积液发生率4.9%(2/41),低于对照组的20.0%(8/40),差异有统计学意义(χ2=4.278,P=0.039)。

结论

乳腺癌改良根治术中局部应用质量浓度2%碘酊,可有效减少引流管引流量及引流管留置时间,预防皮下积液的发生。

Objective

To investigate the efficacy of topical administration of 2% iodine tincture in modified radical mastectomy on reducing subcutaneous effusion.

Methods

From May 2018 to March 2019, a total of eighty-one patients undergoing modified radical mastectomy in the First Affiliated Hospital of Xinxiang Medical University were enrolled prospectively in this study. According to the random number, they were divided into two groups. 41 patients in the trial group were administrated 2% iodine tincture in the surface of operative wounds, and 40 patients in the control group were administrated 0.9% sodium chloride injection. The following data were compared as postoperative drainage volume 1 day, 2 days and 3 days after operation, postoperative drainage tube duration and hospitalization duration, and the incidence of postoperative complications such as subcutaneous effusion and flap necrosis between the two groups.

Results

There were no significant differences in age, body mass index, occupation and education background between the two groups. The postoperative drainage volume 1 day, 2 days and 3 days after operation in the trial group were less than those in the control group, the postoperative drainage tube duration and hospitalization duration were shorter in the trial group compared to the control group, and the differences were statistically significant (t=3.348, 4.421, 2.966, 5.936, 10.070, P=0.001, <0.001, 0.004, <0.001, <0.001). The incidence of flap necrosis after operation in the trial group was 7.3% (3/41), and the control group was 5.0% (2/40), with no satistically significant difference (χ2=0.240, P=0.624). The incidence of subcutaneous effusion after operation in the trial group was 4.9% (2/41), which was lower than 20.0% (8/40) in the control group, the difference was statistically significant (χ2=4.278, P=0.039).

Conclusion

Topical administration of 2% iodine tincture in modified radical mastectomy can effectively reduce postoperative drainage volume, shorten drainage tube duration, and prevent subcutaneous effusion.

表1 两组行乳腺癌改良根治术患者一般临床资料的比较
表2 两组患者乳腺癌改良根治术后引流管引流量、留置引流管时间、住院时间比较(±s
[1]
Chen W, Zheng R, Baade PD, et al. Cancer statistics in China, 2015[J]. CA Cancer J Clin, 2016, 66(2): 115-132.
[2]
王本中. 外科学[M]. 3版. 北京: 人民卫生出版社, 2016: 332-337.
[3]
Siegel R, Desantis C, Virgo K, et al. Cancer treatment and survivorship statistics, 2012[J]. CA Cancer J Clin, 2012, 62(4): 220-241.
[4]
宋尔卫. 外科学[M]. 9版. 北京: 人民卫生出版社, 2018: 243-246.
[5]
Faisal M, Abu-Elela ST, Mostafa W, et al. Efficacy of axillary exclusion on seroma formation after modified radical mastectomy[J]. World J Surg Oncol, 2016, 14(1): 39.
[6]
侯栋,程少华,宋阳, 等. 局部应用碘酊对兔游离皮瓣的影响[J]. 实验动物与比较医学, 2019, 39(1): 46-51.
[7]
中华医学会外科学分会乳腺外科学组,刘荫华,刘真真, 等. 乳腺癌改良根治术专家共识及手术操作指南(2018版)[J]. 中国实用外科杂志, 2018, 38(8): 851-854.
[8]
Zieliński J, Jaworski R, Irga N, et al. Analysis of selected factors influencing seroma formation in breast cancer patients undergoing mastectomy[J]. Arch Med Sci, 2013, 9(1): 86-92.
[9]
Dalberg K, Johansson H, Signomklao T, et al. A randomised study of axillary drainage and pectoral fascia preservation after mastectomy for breast cancer[J]. Eur J Surg Oncol, 2004, 30(6): 602-609.
[10]
陈国林,王凤军,薛英威, 等. 乳腺癌根治术后皮瓣坏死的预防[J]. 中国实用外科杂志, 2001, 21(4): 228-229.
[11]
中华人民共和国国家卫生健康委员会. 乳腺癌诊疗规范(2018年版)[J/CD]. 肿瘤综合治疗电子杂志, 2019, 5(3): 70-99.
[12]
姜书勇. 保乳手术与改良根治术对早期乳腺癌患者的临床疗效及生活质量的影响[J/CD]. 中华普通外科学文献(电子版), 2017, 11(3): 179-182.
[13]
Soares EW, Nagai HM, Bredt LC, et al. Morbidity after conventional dissection of axillary lymph nodes in breast cancer patients[J]. World J Surg Oncol, 2014, 12(1): 67.
[14]
Vasileiadou K, Kosmidis C, Anthimidis G, et al. Cyanoacrylate adhesive reduces seroma production after modified radical mastectomy or quadrantectomy with lymph node dissection-a prospective randomized clinical trial[J]. Clin Breast Cancer, 2017, 17(8): 595-600.
[15]
Khater A, Elnahas W, Roshdy S, et al. Evaluation of the quilting technique for reduction of postmastectomy seroma: A randomized controlled study[J]. Int J Breast Cancer, 2015: 287398.
[16]
Khan MA. Effect of preoperative intravenous steroids on seroma formation after modified radical mastectomy[J]. J Ayub Med Coll Abbottabad, 2017, 29(2): 207-210.
[17]
Kong D, Liu Y, Li Z, et al. OK-432 (Sapylin) reduces seroma formation after axillary lymphadenectomy in breast cancer[J]. J Invest Surg, 2017, 30(1): 1-5.
[18]
毛岸云,张锡贵,倪武, 等. 乳腺癌改良根治术中局部应用沙培林对减少皮下积液的疗效分析[J]. 临床医药实践, 2019, 28(3): 163-166.
[19]
van Bastelaar J, Beckers A, Snoeijs M, et al. Flap fixation reduces seroma in patients undergoing mastectomy: A significant implication for clinical practice[J]. World J Surg Oncol, 2016, 14(1): 66.
[20]
王洪鲁,朱良明,孙志钢, 等. 胸腔镜碘酊胸膜固定术治疗恶性胸腔积液的临床研究[J]. 中国肿瘤临床, 2015, 42(3): 167-172.
[21]
Re RN, Cook JL. An intracrine view of angiogenesis[J]. Bioessays, 2006, 28(9): 943-953.
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