摘要
目的总结便携式负压引流系统在乳腺癌改良根治术应用中存在的问题,并提出解决方案。方法对2013年1月至9月在我院行乳腺癌改良根治术后使用便携式负压引流系统的268例患者的病例资料进行回顾性分析,根据是否使用普通负压球分为双腔组与单腔组两组。统计两组穿刺部位出血的发生率、术后引流量、置管时间及住院时间。结果两组共出现穿刺部位出血23例,其中22例为早期出血,1例为延迟出血。双腔组中胸骨旁引流管置管时间(中位数5.0d)明显少于腋窝引流管(中位数为9.0d;Z=-10.713,P=0.000)。双腔组(以腋窝引流管拔管为准)与单腔组术后置管时间(中位数分别为9.0d和10.0d)、术后住院时间(中位数均为9.0d)差异均无统计学意义。本研究中97.8%(262/268)患者选择带管出院,但出院指导资料缺乏。结论便携式负压引流系统存在穿刺部位出血、无法实现独立计量和独立拔管、出院指导不足等缺点,建议改进穿刺器,采用双腔双管独立引流,增加出院指导资料,使得该引流系统更加完善。
Objective To put forward the problems in applying portable disposable low pressure vacuum drainage system for modified radical mastectomy and to propose the solutions. Methods We retrospectively analyzed the clinical data of 268 breast cancer patients who were treated with portable disposable low pressure vacuum drainage system after receiving modified radical mastectomy in Changhai Hospital from January 2013 to September 2013. Based on the use of ordinary vacuum ball, the patients were divided into dual-chamber group and single-chamber group. The incidence of bleeding at the puncture sites, volume of post-operation drainage, indwelling time of drainage tube, and hospitalization stay were recorded for the two groups. Results A total of 23 cases had puncture site bleeding, including 22 early bleeding and one delayed bleeding. For the dualchamber group, the indwelling time of parasternal drainage tube was significantly shorter than that of axillary drainage tube median： 5.0 d vs 9.0 d, Z=--10. 713, P=0. 000）. The drainage time （median： 9.0 d vs 10.0 d） and hospitalization stays （median： 9.0 d vs 9.0 d） of the two groups were not significantly different. It was found that 97.8% （262/268） of the patients in this study were discharged early with a drain, but with lack of discharge guidance. Conclusion Disadvantages of portable disposable low pressure vacuum drainage system include puncture site bleeding, drainage tube cannot be extubated independently and measurement cannot be done independently, and insufficient discharge guidance. Improvement of puncture device, use of double-lumen tube independent drainage, and improvement of discharge guidance should be made to improve the system.
出处
《第二军医大学学报》
CAS
CSCD
北大核心
2014年第6期681-683,共3页
Academic Journal of Second Military Medical University
关键词
乳腺肿瘤
乳腺癌改良根治术
便携式负压引流系统
缺点
breast neoplasms
modified radical mastectomy
portable disposable low pressure vacuum drainage systems disadvantage
