标本皮肤移植对较大病灶乳腺癌术后皮瓣坏死的预防作用

摘要

目的:研究标本皮肤移植对较大乳腺癌术后皮瓣坏死的预防作用.方法:回顾性分析201 5年1-1 1月接受手术治疗的乳腺癌患者1 1 6例,接受标本皮肤移植58例,记为观察组;未接受标本皮肤移植者58例,记为对照组,对比两组术后皮瓣坏死情况,手术指标(手术时间、住院时间、随访时间及二次植皮比例),以及手术前后的白细胞介素-1 3 (IL-1 β)、白细胞介素-6(IL-6)及肿瘤坏死因子-α(TNF-α)水平.结果:观察组全层皮瓣坏死的比例为0,皮瓣坏死总发生率为8.62％,均分别低于对照组的8.62％及25.86％,差异有统计学意义(P＜0.05).观察组的住院时间及二次植皮比例均分别少于对照组,差异有统计学意义(P＜0.05).两组术后IL-1β、IL-6及TNF-α水平均分别低于术前,差异有统计学意义(P＜0.05).观察组术后的IL-1β、IL-6及TNF-α水平均分别低于对照组,差异有统计学意义(P＜0.05).结论:对于较大肿块的乳腺癌患者,在明确植皮皮肤边缘不存在癌残留的前提下,通过标本皮肤移植能够较好地预防术后皮瓣坏死,同时可促进患者康复,效果较好,值得给予推荐.%Objective:To study the prevention effect of specimen skin transplantation for skin flap necrosis after breast cancer surgery.Methods:A retrospective analysis of 116 patients with breast cancer treated by surgery from January 2015 to November 2015 was reviewed,with skin graft in 58 cases,recorded as the observation group;skin graft was not accepted in 58 cases,as the control group,compared skin flap necrosis rate between the two groups after the operation,the operation index (operation time,hospitalization time,follow-up time and two times the proportion of skin graft),and before and after the operation of the IL-1 β,IL-6 and TNF-α levels.Resultes:The observation group of full-thickness skin flap necrosis of skin flap necrosis ratio was 0,the total incidence rate was 8.62％,which were significantly lower than the control group of 8.62％ and 25.86％,the differences were statistically significant(P＜0.05).Hospitalization time of the observation group and two skin graft ratio were significantly less than the control group,the differences were statistically significant (P＜0.05).The two groups after the IL-1 β,IL-6 and TNF-α respectively was significantly lower than that before treatment,the difference was statistically significant (P＜0.05).The patients in the observation group of IL-1 β,IL-6 and TNF-α respectively was significantly lower than the control group,the difference was statistically significant (P＜0.05).Conclusions:For large masses of breast cancer patients,under the premise of clear skin edge there is no residual cancer,through specimen skin transplantation can better prevention of skin flap necrosis after,at the same time,can promote the rehabilitation of patients,the effect is good,it is worth to give recommendation.