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乳房切除术后使用多个引流管会增加患者的不适,并延长术后住院时间。

Use of multiple drains after mastectomy is associated with more patient discomfort and longer postoperative stay.

机构信息

Department of General Surgery, Russells Hall Hospital, Dudley, UK.

出版信息

Clin Breast Cancer. 2009 Nov;9(4):243-6. doi: 10.3816/CBC.2009.n.041.

Abstract

BACKGROUND

Seromas constitute a common complication following surgery for breast cancer, and closed drainage is used routinely to reduce its incidence. The aim of this study was to evaluate the influence of number of drains on patient discomfort, seroma formation, and hospital stay during the immediate postoperative period after mastectomy for breast cancer.

PATIENTS AND METHODS

Based on a retrospective review of our clinical database, 110 consecutive patients from January 2004 through January 2006 who had undergone a mastectomy and axillary clearance for breast cancer were sent a simple postal questionnaire for collection of data.

RESULTS

A total of 70 patients responded (all women; mean age, 69.4 +/- 11.4 years). Twenty-seven patients (38.57%) had 3 drains implanted unilaterally, 24 (34.28%) had 2, and 19 (27.14%) had 1 drain. They were divided into 2 groups: the first group with 1 drain (19 patients) and the other with 2 or 3 drains (51 patients). Median postoperative hospital stay was 2 days (range, 1-8 days); patients with 1 drain had a significantly shorter postoperative hospital stay (median, 2 days [range, 1-4 days] vs. 2 days [range, 1-8 days]; Mann-Whitney U test, P = .02). A total of 15 patients (21.43%) complained of a seroma. There was no difference in seroma rates between groups. Patients who had a single drain implanted had a significantly lower rate of discomfort (median, 2 [range, 1-5] vs. 3 [range, 1-7]; Mann-Whitney U test; P = .04).

CONCLUSION

The number of drains used after a mastectomy for breast cancer did not significantly affect the rate or amount of seromas in this study, but the use of a single drain after mastectomy was significantly associated with less discomfort and shorter postoperative hospital stay.

摘要

背景

乳房手术后的血清肿是一种常见的并发症,通常使用闭式引流来降低其发生率。本研究旨在评估乳腺癌乳房切除术后引流管数量对患者不适、血清肿形成和术后即刻住院时间的影响。

方法

基于对我们临床数据库的回顾性分析,我们向 2004 年 1 月至 2006 年 1 月期间因乳腺癌接受乳房切除术和腋窝清扫术的 110 例连续患者发送了一份简单的邮寄问卷以收集数据。

结果

共有 70 名患者(均为女性;平均年龄 69.4 ± 11.4 岁)做出了回应。27 名患者(38.57%)单侧植入 3 根引流管,24 名(34.28%)植入 2 根,19 名(27.14%)植入 1 根。他们被分为两组:一组有 1 根引流管(19 名患者),另一组有 2 或 3 根引流管(51 名患者)。中位术后住院时间为 2 天(范围,1-8 天);有 1 根引流管的患者术后住院时间明显缩短(中位数,2 天[范围,1-4 天]与 2 天[范围,1-8 天];Mann-Whitney U 检验,P =.02)。共有 15 名患者(21.43%)抱怨有血清肿。两组之间的血清肿发生率没有差异。植入单根引流管的患者不适发生率明显较低(中位数,2[范围,1-5]与 3[范围,1-7];Mann-Whitney U 检验;P =.04)。

结论

在本研究中,乳腺癌乳房切除术后使用引流管的数量并没有显著影响血清肿的发生率或量,但乳房切除术后使用单根引流管与术后不适程度较低和术后住院时间较短显著相关。

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