乳腺癌腋窝淋巴结清扫术中行吸脂术的临床意义

摘要

目的:探讨乳腺癌腋窝淋巴结清扫术中行吸脂术的临床意义.方法:将120例行乳癌改良根治术的患者随机分成观察组和对照组.观察组术中于腋窝注射脂肪溶解液行吸脂术后清扫腋窝淋巴结.对照组行传统腋窝淋巴结清扫术.对两组手术时间、术中出血量、清扫淋巴结数目、术后引流量、平均拔管天数、患肢疼痛、患肢提肩运动障碍、患肢水肿等指标对比分析.结果:观察组术中清扫淋巴结(19.1±3.19)枚,较对照组(13.2±3.84)枚显著增多;观察组和对照组手术时间分别为(119.7±17.8)min和(98.6±16.3)min;术中出血量分别为(85.9±15.6)mL和(113.4±13.2)mL;拔管天数各为(5.6±0.3)d和(11.8±1.2)d,差异均具统计学意义(P＜0.05).观察组术后患肢疼痛、提肩运动障碍、患肢水肿等并发症的发生率低于对照组(P<0.05).亚组分析显示,该方法在肥胖患者中能取得更好的效果.结论:乳腺癌腋窝淋巴结清扫术中行吸脂术可清晰暴露腋窝,使清扫更彻底,避免损伤腋窝重要神经、血管及淋巴管,减少了术后并发症,值得临床推广.%Objective:To explore the clinical significance of liposuction in axillary lymph node dissection of breast cancer.Methods: 120 female patients who underwent modified radical mastectomy were randomly divided into observation group and control group.In the observation group, axillary lymph nodes were dissected after liposuction.The control group received traditional axillary lymph node dissection.Contrastive analysis was made between two groups: operation time, blood loss, number of lymph nodes, postoperative drainage, average extubation days, limb pain, shoulder movement disorders and limb edema.Results: In observation group, the average 19 lymph nodes per patient, much more than the control group of 13;the blood loss and postoperative drainage, less than the control group;mean extubation time earlier than the control group;However, the operation time was longer than the control group(P<0.05).4 cases observed of limb pain, 18 cases in the control group;shoulder movement disorders observation group 3 cases, 15 cases in the control group;1 case occurred limb edema in observation group, in the control group had 8 cases of upper limb edema, postoperative complications were significantly differences (P <0.05).Subgroup analysis showed that the method can achieve better results in obese patients.Conclusions: The efficacy for liposuction in the axillary lymph node dissection of breast cancer has the following advantages: clearly exposed armpit, remove adequate lymph nodes, less nerves, blood vessels and lymphatic vessels injured, and fewer postoperative complications, is worthy of clinical further promotion.