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目的改进乳腺癌术中腋窝淋巴结清扫的手术方式,减少术后并发症及局部畸形的发生。方法118例乳腺癌患者随机分为改良组和对照组。改良组应用肿胀技术充盈腋筋膜使腋窝各壁与腋筋膜的界限清晰,血管神经与淋巴结之间间隙增宽,清扫中有利于保护血管神经免受损伤;同时保留了完整的腋窝壁减少术后局部畸形的发生;应用生物蛋白胶进行创面涂抹闭合开放的小血管和淋巴管。结果改良组术后局部疼痛、患肢功能障碍、患肢淋巴水肿、腋窝积液和腋窝畸形程度等的发生均明显低于对照组。结论应用腋窝肿胀技术可有效保护血管神经和腋窝周壁的完整,生物蛋白胶局部应用可有效闭合开放的血管和淋巴管,从而减少术后局部畸形和并发症的发生,促进伤口愈合。
Objective To improve the operation of axillary lymph node dissection in breast cancer and reduce the incidence of postoperative complications and local deformity. Methods 118 cases of breast cancer were randomly divided into modified group and control group. In the modified group, swelling was used to fill the armpit fascia so that the boundaries between armpit walls and armpit fascia were clear, the gap between vascular nerves and lymph nodes was broadened, and the vascular nerves were protected from injury during the dissection. At the same time, intact axillary wall was preserved Postoperative local deformity occurs; the application of biological protein glue for wound dressing open small blood vessels and lymphatic vessels. Results The postoperative local pain, limb dysfunction, limb lymphedema, axillary effusion and armpit deformity in the modified group were significantly lower than those in the control group. Conclusion The application of armpit swollen technique can effectively protect the integrity of the vascular nerves and the armpit wall. Local application of biological protein glue can effectively close open blood vessels and lymphatic vessels, thereby reducing postoperative local deformities and complications and promoting wound healing.