凝血酶治疗乳腺癌根治术后皮下积液的疗效观察

目的探讨凝血酶治疗乳腺癌根治术后皮下积液的疗效。方法对我院2008年7月至2013年7月期间收治的190例行乳腺癌改良根治术后的患者根据手术时间顺序交替分组研究,术后观察组术后3 d每天由引流管注入凝血酶,对照组仅行负压引流,统计2组术后72 h引流总量、拔管时间及拔管后皮下积液例数;对拔管后出现皮下积液患者根据拔管时间顺序交替分组,皮下积液观察组抽尽积液后采用凝血酶皮下积液腔注射并加压包扎处理,对照组仅行穿刺抽液并加压包扎处理,统计2组的皮下积液愈合时间。结果术后观察组术后72 h引流总量明显少于术后对照组（P〈0.001）,拔管时间明显早于术后对照组（P〈0.001）,拔管后皮下积液发生率明显低于术后对照组（P〈0.05）,术后第2 d引流液颜色明显较术后对照组浅（P〈0.001）。皮下积液观察组皮下积液平均愈合时间在积液量少的患者中与皮下积液对照组比较差异无统计学意义（P〉0.05）;在中或大量积液患者中皮下积液平均愈合时间较皮下积液对照组明显缩短（P〈0.05）。结论术后由引流管注入凝血酶可明显减少引流量并缩短拔管时间,降低皮下积液发生率,对中～大量术后皮下积液患者行凝血酶皮下积液腔内注射可促进愈合,缩短愈合时间。

Curative Effect Observation of Thrombin in Treatment of Subcutaneous Effusion Following Radical Resection of Breast Cancer

Objective To explore the efficacy of thrombin in treatment of subcutaneous effusion after radical resection of breast cancer. Methods One hundred and ninety patients underwent radical resection of breast cancer from July 2008 to July 2013 in this hospital were divided into postoperative observation group and postoperative control group according to the operation time. A daily injection of thrombin by drainage tube was performed on day 3 after operation in the postoperative observation group, the negative pressure drainage only was performed in the postoperative control group. The drainage volume in 72 h after operation, time of extubation, cases of subcutaneous effusion were counted after operation. Then the patients with subcutaneous effusion were divided into subcutaneous effusion observation group and subcutaneous effusion control group according to the time of extubation, the thrombin was injected into cavity after pumping subcutaneous effusion with pressing and dressing in the subcutaneous effusion observation group and only pressed after pumping subcutaneous effusion in the subcutaneous effusion control group, respectively. The healing time of subcutaneous effusion was counted in these two groups. Results Compared with the postoperative control group, the drainage volume in 72 h after operation was less （P 〈 0. 001）, the time of extubation was earlier （P 〈 0. 001）, the rate of subcutaneous effusion was lower （P〈0. 05）, color of drainage fluid on day 2 after mastectomy was lighter （P〈0. 001） in the postoperative observation group. Compared with subcutaneous effusion control group, when subcutaneous effusion was 20-50 mL or 〉 50 mL, the healing time of subcutaneous effusion was significantly shorter in the subcutaneous effusion observation group （P 〈 0. 05）. Conclusions Injecting thrombin by drainage tube after operation can reduce the drainage volume, decrease the rate of subcutaneous liquid, and shorten the time of extubation. Injecting thrombin into cavity of subcutaneous li