乳腺癌改良根治术后出血原因分析(1)
【摘要】 目的 对乳腺癌改良根治术后出血原因进行分析， 为临床防治术后出血提供借鉴。方法 对行乳腺癌改良根治术后出血的6例患者的临床资料进行回顾性分析， 寻找出血原因。结果 术后首日引流量6例中5例≥100 ml， 平均引流量204 ml；1例长期口服抗精神病药物；1例乳腺癌复发转移正口服希罗达维持治疗。1例急诊手术止血， 余5例给予加压包扎止血， 均治愈。6例无一例出现皮瓣坏死， 1例出现局部切口感染。结论 为防治乳腺癌改良根治术后出血， 术中术后需合理控制血压， 术中需及时止血， 注意围手术期药物的使用， 正确适当的加压包扎。
【关键词】 出血；乳腺癌；改良根治术
DOI：10.14163/j.cnki.11-5547/r.2015.14.019
Analysis of hemorrhage causes after modified radical operation for breast cancer LUO Guo-qing， HU Ning-dong， GUO Yuan-feng， et al. Affiliated Qingyuan Hospital of Medical School of Jinan University/Qingyuan City People’s Hospital， Qingyuan 511518， China
, 百拇医药
【Abstract】 Objective To analyze hemorrhage causes after modified radical operation for breast cancer， and to provide reference for clinical prevention and treatment of postoperative hemorrhage. Methods A retrospective analysis was made on the clinical data of 6 patients with postoperative hemorrhage after modified radical operation for breast cancer， in order to find their hemorrhage causes. Results There were 5 cases among the 6 cases had drainage volume ≥100 ml at the first postoperative day， with an average drainage volume as 204 ml. There were 1 case with long-term oral administration of antipsychotics and 1 case with oral administration of capecitabine for maintenance treatment of relapsed breast cancer. 1 case received emergency surgical hemostasis， and the other 5 cases were given compression bandage hemostasis. All cases were cured without any case with skin flap necrosis， while there was 1 case with local incision infection. Conclusion Prevention and treatment of hemorrhage after modified radical operation for breast cancer requires intraoperative and postoperative blood pressure control and intraoperative timely hemostasis. Drug use in perioperative period and appropriate compression bandage are also necessary.
, http://www.100md.com
【Key words】 Hemorrhage； Breast cancer； Modified radical operation
乳腺癌改良根治术为目前手术治疗乳腺癌的常用术式之一[1]。提高手术的质量对患者生理、心理康复以及及时的进行后续治疗至关重要。改良根治术常见的手术并发症有术后出血、皮下积液、皮瓣坏死等[2]。2013年7月～2014年8月， 本科行乳腺癌改良根治术64例， 发生术后出血6例。术后出血后易伴随出现局部感染、皮瓣坏死， 进而导致伤口处理时间较长， 影响患者的后续治疗。故对此6例术后出血进行原因分析， 为临床防治术后出血提供借鉴。现报告如下。
1 资料与方法
1. 1 一般资料 本科2013年7月～2014年8月行乳腺癌改良根治术64例， 发生术后出血6例。均为女性， 年龄35～73岁， 平均年龄48岁。
1. 2 术后出血的判断标准 ①引流管持续引出颜色较深血性液体；②患者出现心率增快、血压下降、头晕、化验提示血色素下降等失血表现；③术区出血肿胀伴/不伴大片瘀斑；④术区穿刺抽出明显颜色较深血性液体；⑤拆除少许缝线后见术区明显血凝块。满足上述一项或以上条件即可判断为术后出血。
1. 3 手术方式 对临床腋窝淋巴结阴性的早期乳腺癌患者， 行前哨淋巴结活检， 若前哨淋巴结阴性， 则行单纯切乳+前哨淋巴结活检， 共3例；若前哨淋巴结阳性或前哨淋巴结活检失败或临床腋窝淋巴结阳性， 则行切乳+腋窝清扫， 共3例。, 百拇医药(罗国庆 胡宁东 郭远峰 周晶晶)
【关键词】 出血；乳腺癌；改良根治术
DOI：10.14163/j.cnki.11-5547/r.2015.14.019
Analysis of hemorrhage causes after modified radical operation for breast cancer LUO Guo-qing， HU Ning-dong， GUO Yuan-feng， et al. Affiliated Qingyuan Hospital of Medical School of Jinan University/Qingyuan City People’s Hospital， Qingyuan 511518， China
, 百拇医药
【Abstract】 Objective To analyze hemorrhage causes after modified radical operation for breast cancer， and to provide reference for clinical prevention and treatment of postoperative hemorrhage. Methods A retrospective analysis was made on the clinical data of 6 patients with postoperative hemorrhage after modified radical operation for breast cancer， in order to find their hemorrhage causes. Results There were 5 cases among the 6 cases had drainage volume ≥100 ml at the first postoperative day， with an average drainage volume as 204 ml. There were 1 case with long-term oral administration of antipsychotics and 1 case with oral administration of capecitabine for maintenance treatment of relapsed breast cancer. 1 case received emergency surgical hemostasis， and the other 5 cases were given compression bandage hemostasis. All cases were cured without any case with skin flap necrosis， while there was 1 case with local incision infection. Conclusion Prevention and treatment of hemorrhage after modified radical operation for breast cancer requires intraoperative and postoperative blood pressure control and intraoperative timely hemostasis. Drug use in perioperative period and appropriate compression bandage are also necessary.
, http://www.100md.com
【Key words】 Hemorrhage； Breast cancer； Modified radical operation
乳腺癌改良根治术为目前手术治疗乳腺癌的常用术式之一[1]。提高手术的质量对患者生理、心理康复以及及时的进行后续治疗至关重要。改良根治术常见的手术并发症有术后出血、皮下积液、皮瓣坏死等[2]。2013年7月～2014年8月， 本科行乳腺癌改良根治术64例， 发生术后出血6例。术后出血后易伴随出现局部感染、皮瓣坏死， 进而导致伤口处理时间较长， 影响患者的后续治疗。故对此6例术后出血进行原因分析， 为临床防治术后出血提供借鉴。现报告如下。
1 资料与方法
1. 1 一般资料 本科2013年7月～2014年8月行乳腺癌改良根治术64例， 发生术后出血6例。均为女性， 年龄35～73岁， 平均年龄48岁。
1. 2 术后出血的判断标准 ①引流管持续引出颜色较深血性液体；②患者出现心率增快、血压下降、头晕、化验提示血色素下降等失血表现；③术区出血肿胀伴/不伴大片瘀斑；④术区穿刺抽出明显颜色较深血性液体；⑤拆除少许缝线后见术区明显血凝块。满足上述一项或以上条件即可判断为术后出血。
1. 3 手术方式 对临床腋窝淋巴结阴性的早期乳腺癌患者， 行前哨淋巴结活检， 若前哨淋巴结阴性， 则行单纯切乳+前哨淋巴结活检， 共3例；若前哨淋巴结阳性或前哨淋巴结活检失败或临床腋窝淋巴结阳性， 则行切乳+腋窝清扫， 共3例。, 百拇医药(罗国庆 胡宁东 郭远峰 周晶晶)