乳腺癌改良根治术改进对减少并发症临床研究.docVIP

乳腺癌改良根治术改进对减少并发症临床研究 　　【摘要】目的:研究乳腺癌改良根治术的改进对减少并发症的效果。方法:改进组：(1)30例乳腺癌患者在进行手术前的一个星期内实行单次小剂量的辅助化疗。(2)取横形切口。(3)对于左侧乳腺癌患者采取从锁骨下、胸骨旁以及肋缘上的顺序切除乳房,对于右侧乳腺癌患者则采取从胸骨旁以及锁骨下肋骨旁的顺序切除乳房。(4)电凝刀游离支瓣。(5)保留肋间臂神经。(6)在手术后实行负压引流。(7)实行术后化疗。对照组：选择常规的手术治疗。结果:改进组:患侧上肢水肿2例，小面积皮瓣坏死3例，切口下少量积液5例，短期内同侧腋窝及上肢内侧感觉障碍5例。对照组:上肢水肿9例，皮瓣坏死8例,切口皮下特别积液7例,腋窝及上肢内侧感觉障碍8例。结论:改良根治术的改进,不仅可以使患者手术后乳房外形饱满，达到彻底根治乳腺癌的目的，而且可以最大限度地降低乳腺癌并发症的发生率，有助于患者身体的康复。 　　【关键词】乳腺癌改良根治术；改进；并发症Improvement of the improvement of breast cancer treated to 　　reduce the complications of clinical research 　　WangXiong 　　【Abstract】 objective to study the improvement of the improvement of breast cancer treated the effect of reducing complications. Methods: (1) improve group of 30 cases of breast cancer patients underwent surgery in a week prior to single time in small doses of adjuvant chemotherapy. (2) the incision take shape. (3) for the left breast cancer patients taken from subclavian, the sternum and costal margin of resection on order breast, to the right breast cancer patients from the sternum is taken and the order of the subclavian rib resection of the breast. (4) of the sword with free flap. (5) keep intercostals arm nerve. (6) of the negative pressure drainage the surgery. (7) execute postoperative chemotherapy. The control group: the choice of conventional surgery. Results improve group: of the upper limbs edema (2), the small area of skin flap necrosis in 3, 5 cases under a small incision fluid, the short term and the upper lateral armpit feels obstacle in 5 patients. The control group: upper limbs edema 9 cases, 8 cases of skin flap necrosis, the incision subcutaneous special effusion in 7 cases, armpits and upper limbs inside feels obstacle 8 cases. Conclusion the improvement of the improved vesssed can not only make patients after surgery full breast appearance, to eradicate the purpose of breast cancer, and can maximize reduce breast cancer incidence of complications, help patients recovery. 　　【Key words】 breast cancer treated