超声刀在乳腺癌Auchincloss改良根治术中

【】　目的　比较在乳腺癌Auchincloss改良根治术中使用超声刀及电刀手术的优、缺点。　方法　2009年6月－2010年7月将176例乳腺癌患者通过信封法随机分为超声刀组和电刀组，每组88例，分别比较两组患者手术时间、术中出血量、淋巴结检出数目、术后引流量、皮下积液及术后出血量的差异。　结果　手术时间超声刀组为（145.72±50.76）min，电刀组为（171.27±66.68）min，两组差异有统计学意义（P=0.005）；术中出血量超声刀组为（71.56±31.34）mL，电刀组为（84.99±36.39）mL，两组差异有统计学意义（P=0.009）；清扫出的淋巴结个数超声刀组为（20.92±9.09）个，电刀组为（17.90±6.74）个，两组差异有统计学意义（P=0.013）。而在术后平均引流量和术后积液例数方面两组的差异无统计学意义（P>0.05）。两组均无术后出血的情况。　结论　在乳腺癌Auchincloss改良根治术中使用超声刀，较单独使用电刀能缩短手术时间，减少出血量，并增加淋巴结检出的数量。【Abstract】　Objective　Tocomparethedisadvantagesandadvantagesbetweenmodifiedradicalmastectomywithharmonicscalpel(HS)andconventionalelectro-scalpel(ES)forpatientswithbreastcancer.　Methods　BetweenJune2009andJuly2010,176patientswithbreastcancerwererandomlydividedintotwogroupsincludingtheHSgroupandtheESgroup.Theoperationtime,intra-operativebleedingvolume,thenumberoflymphnodesdetected,postoperativedrainagevolume,subcutaneoushydrops,andpostoperativehemorrhagevolumebetweenthetwogroupsofpatientswerecompared.　Results　ThereweresignificantdifferencesbetweentheHSandESgroupsintermsofoperationtime(145.72±50.76)minutesvs.(171.27±66.68)minutes,P=0.005,intra-operativebleedingvolume(71.56±31.34)mLvs.(84.99±36.39)mL,P=0.009,andnumberoflymphnodesdetected(20.92±9.09vs.17.90±6.74,P0.05).Nopostoperativehemorrhageoccurredinbothgroups.　Conclusion　ComparedwithES,theuseofHScanreduceoperationtimeandintra-operativebleedingvolume,andincreasethenumberoflymphnodesdetectedduringmodifiedradicalmastectomy.