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投稿时间:2018-04-24 网络发布日期:2018-09-20
投稿时间:2018-04-24 网络发布日期:2018-09-20
中文摘要: 目的 探讨双极电凝止血联合手术刀切割预防乳腺癌患者围手术期心血管危险事件发生的价值。方法 回顾性分析2011年9月到2017年1月在中山大学附属第八医院行乳腺癌根治术182例患者的临床资料,根据术中止血方法的不同分为观察组100例与对照组82例。
观察组术中用手术刀进行切割,配合使用双极电凝止血;对照组切割皮肤使用手术刀,切割及止血使用电刀。观察两组预后,记录围手术期心血管危险事件发生情况。结果 两组手术时间、术中出血量对比无明显差异(P>0.05),观察组的术后拔管时间明显早于对照组(P<0.01)。观察组围手术期的皮下积液发生率(3.0% vs 11.0%,P<0.05)明显低于对照组;淋巴水肿发生率稍低于对照组(1.0% vs 7.3%),但差异无统计学意义(P>0.05)。观察组围手术期的心血管危险事件发生率明显少于对照组(2.0% vs 12.2%,P<0.01)。术后1个月观察组的生活质量评分中角色、躯体、认知、情绪、社会评分都明显低于对照组(P<0.05)。结论 双极电凝止血联合手术刀切割能有效预防乳腺癌者围手术期心血管危险事件的发生,减少皮下积液的发生,术后拔管时间提早,从而提高患者的整体生活质量。
Abstract:Objective To investigate the values of bipolar electrocoagulation hemostasis combined with scalpel cutting in preventing the occurrence of cardiovascular risk events of perioperative period in patients with breast cancer. Methods A total of 182 patients who received breast cancer radical mastectomy in the Eighth Affiliated Hospital of Sun Yat-sen University from September 2011 to January 2017 were selected as research objects. According to the different methods of hemostasis during the operation, the patients were divided into observation group (n=100) and control group (n=82). Scalpel cutting cooperated with bipolar electrocoagulation hemostasis was used in observation group. Scalpe for cutting skin and electric knife for cutting and hemostasis were used in control group. The prognosis of patients in two groups was observed, and the cardiovascular risk events in two groups were recorded. Results There were no significant differences in operation time and intraoperative blood loss between two groups (all P>0.05). The postoperative time to extubation in observation group was significantly earlier compared with control group (P<0.05). The incidences of subcutaneous hydrops (3.0% vs 11.0%, P<0.05)during perioperative period in observation group were significantly less than that in control group. The incidence of cardiovascular risk events of perioperative period was significantly less than that in control group (2.0% vs 12.2%, P<0.01). The scores of role, body, cognition, emotion, society items for quality of life score at 1 month after operation in observation group were significantly less than those in control group (all P<0.01). Conclusion Bipolar electrocoagulation hemostasis combined with scalpel cutting can effectively prevent the occurrence of perioperative cardiovascular risk events, decrease the occurrence of subcutaneous effusion, lymphedema and promote the postoperative extubation time early, so as to improve the overall life quality of the patients.
文章编号: 中图分类号:R 737.9 R 61 文献标志码:A
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引用文本:
张卫星,邓卫萍,袁璐,李明,余利娃,陈庸.双极电凝联合手术刀预防乳腺癌者围手术期心血管危险事件发生的价值[J].中国临床研究,2018,31(9):1224-1227.
张卫星,邓卫萍,袁璐,李明,余利娃,陈庸.双极电凝联合手术刀预防乳腺癌者围手术期心血管危险事件发生的价值[J].中国临床研究,2018,31(9):1224-1227.