乳腺癌术后常见并发症的防治

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1、乳腺癌术后常见并发症的防治【摘要】目的：探讨乳癌术后常见并发症的防治方法。方法：通过对20021～20053月122例实施乳癌根治术的病例资料进行回顾性分析总结。结果：皮下积液12例，皮瓣坏死6例;上肢淋巴水肿6例。少量积液一般不需要处理，积液大于5ml每天可抽吸，然后加压包扎，积液量>50ml时可拆除1针缝线或切开放置引流管，时间最长达半个月。皮瓣坏死<3cm，行换药处理;>3cm给予切痂、植皮处理。上肢淋巴水肿轻中度水肿不需特殊处理，重度水肿进行上肢功能锻炼，应用透热疗法后好转，所有患者均痊愈

2、出院。结论：手术前合理的设计切口，术中仔细操作，适当加压包扎，保持负压通畅，术后经常锻炼上肢功能，对于乳癌根治术后皮下积液、皮瓣坏死、上肢淋巴水肿的防治十分重要，可使乳癌术后并发症的发生降到最低，使乳癌患者继续进入下一步的综合治疗。【关键词】乳腺癌；并发症；防治【ABSTRACT】Objective:Toinvestigatethepreventionandtreatmentforcomplicationsaftermastectomy.Methods:Tomakearetrospectiveanalysisfor

3、theaccumulativeliquidofsubcutaneaandskinflapnecrosisswelloftheilledlateralupperarmin122casesfromJanuary2002toMarch2005.Results:Inthesepatients，therewere12caseswithaccumulativeliquid9ofsubcutaneous,6caseswithskinflapnecrosisand6caseswithswelloftheilledlateralup

4、perarm.Therewasalittleaccumalatedamountofliquidandgenerallydidnotneedtobeprocessed.Everydayitwassuckedrepeatedlywhentheaccumulatedliquidwasmorethan5ml，andthenitwaspressedandtiedup.Iftheliquidwasover50ml,theneedlesuturecouldbetoredownandcuttoresetthedrainpipe，t

5、helongesttimewas15days.Skinflapnecrosisshouldbelessthan3cmandtheprocesswastransitionmedicinedressing.Ifitexceeded3cm,scrabshouldbecutandtheskinshouldbereset.Forswellingofupperlateralarm,lightdegreeswellingdidntneedtreatment,butforseveredegreeofswellingthepatie

6、ntsneededfunctionalphysicalexerciseandheattransparenttreatment,andtheycouldbecured.Conclusion:Reasonabledesigningtheoperationincision，carefuloperation,wrappingupwithpressureandfunctionalexerciseareveryimportantfortreatingsubcutaneousliquid,skinflapnecrosisands

7、wellingofupperlateralarm.Itcanmakethepatientwithbreastcancertohavefurthertreatment.【KEYWORDS】Breastcancer;Complication;Preventtreat9随着乳腺癌根治手术的多样化，皮下积液、皮瓣坏死、上肢淋巴水肿成为乳癌根治术后常见并发症，发生后影响对患者的进一步治疗及预后，因此，如何防治术后并发症的发生十分重要。我科20021～20053月共实施乳癌根治术122例，并发皮下积液、皮瓣坏死、上肢淋巴水肿共

8、24例，现介绍如下。1资料与方法11一般资料我科20021～20053月共实施乳癌根治术122例，手术类型:Halsted手术50例，Auchincloss手术34例，PateyDyson手术38例，均为女性，全部经病理证实，年龄24～69（43±10）岁。右侧62例，左侧60例;肿块位于外上象限90例，内上象限24例，中央区6例，外下象限2例;临床分期:Ⅰ