Curative Effect Observation of Thrombin in Treatment of Subcutaneous Effusion Following Radical Resection of Breast Cancer_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 ZHOUWen ,  TANCheng , ZOUWei , BENE-yi , LIAOFeng-lin

Department of Oncological Surgery, The First People's Hospital of Yidu, Yidu 443300, Hubei Province, China;

Corresponding author：

TANCheng, Email: wdeng_12@163.com

Keywords：

Thrombin; Breast cancer; Subcutaneous effusion

DOI：

10.7507/1007-9424.20140239

Video：

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Objective To explore the efficacy of thrombin in treatment of subcutaneous effusion after radical resection of breast cancer. Methods One hundred and ninety patients underwent radical resection of breast cancer from July 2008 to July 2013 in this hospital were divided into postoperative observation group and postoperative control group according to the operation time. A daily injection of thrombin by drainage tube was performed on day 3 after operation in the postoperative observation group, the negative pressure drainage only was performed in the postoperative control group. The drainage volume in 72 h after operation, time of extubation, cases of subcutaneous effusion were counted after operation. Then the patients with subcutaneous effusion were divided into subcutaneous effusion observation group and subcutaneous effusion control group according to the time of extubation, the thrombin was injected into cavity after pumping subcutaneous effusion with pressing and dressing in the subcutaneous effusion observation group and only pressed after pumping subcutaneous effusion in the subcutaneous effusion control group, respectively. The healing time of subcutaneous effusion was counted in these two groups. Results Compared with the postoperative control group, the drainage volume in 72 h after operation was less(P < 0.001), the time of extubation was earlier(P < 0.001), the rate of subcutaneous effusion was lower(P < 0.05), color of drainage fluid on day 2 after mastectomy was lighter(P < 0.001)in the postoperative observation group. Compared with subcutaneous effusion control group, when subcutaneous effusion was 20-50 mL or > 50 mL, the healing time of subcutaneous effusion was significantly shorter in the subcutaneous effusion observation group(P < 0.05). Conclusions Injecting thrombin by drainage tube after operation can reduce the drainage volume, decrease the rate of subcutaneous liquid, and shorten the time of extubation. Injecting thrombin into cavity of subcutaneous liquid can shorten the healing time of patients with middle and large subcutaneous effusions after radical resection of breast cancer.

Citation： ZHOUWen, TANCheng, ZOUWei, BENE-yi, LIAOFeng-lin. Curative Effect Observation of Thrombin in Treatment of Subcutaneous Effusion Following Radical Resection of Breast Cancer. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2014, 21(8): 996-1000. doi: 10.7507/1007-9424.20140239 Copy

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10.	董龙庆, 于栋梁, 徐龙君.乳腺癌术后皮下积液与皮瓣坏死的防治[J].临床医学, 2012, 32(12): 18-20.
11.	张彦收, 焦俊琴, 卞晓丽, 等.可吸收止血海绵在乳腺癌改良根治术中应用的效果观察[J].临床外科杂志, 2012, 20(4): 250-251.
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15.	鲁武伟, 彭杏芳.不同处理方法防治乳腺癌术后皮下积液的临床效果观察[J].中国伤残医学, 2013, 21(2): 80-81.
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23.	马少林, 李润浦, 王艳丽, 等.博莱霉素联合白介素-2及凝血酶治疗恶性胸腔积液的临床观察[J].现代肿瘤医学, 2013, 21(3): 557-559.
24.	吕章春, 胡谷冰, 朱佩贞.博来霉素联合凝血酶对恶性血性胸水的疗效观察[J].肿瘤防治研究, 2002, 29(3): 236-237.
25.	周学敏, 朱铁年, 金普乐, 等.凝血酶治疗癌性胸腔积液的临床观察[J].中华结核和呼吸杂志, 1996, 19(4): 50.

1. 郑向欣, 管小青, 吴骥, 等.乳腺癌术后皮下积液发生原因及防治(附204例报告)[J].医学理论与实践, 2014, 26(4): 434-435.
2. Han J, Grothuesmann D, Neises M, et al. Quality of life and satisfaction after breast cancer operation[J]. Arch Gynecol Obstet, 2010, 282(1): 75-82.
3. Dalberg K, Johansson H, Signomklao T, et al. A randomised study of axillary drainage and pectoral fascia preservation after mastectomy for breast cancer[J]. Eur J Surg Oncol, 2004, 30(6): 602-609.
4. 莫春连, 何沙, 卢永刚.乳腺癌改良根治术后皮下积液的发生原因与防治[J].实用癌症杂志, 2012, 27(4): 382-383, 388.
5. 路忠志, 李东生, 李丽.乳腺癌术后皮瓣坏死及皮下积液原因及处理[J/CD].中华普通外科学文献:电子版, 2010, 4(4): 385-388.
6. 沈俊, 邱园华, 王林波.乳腺癌术后积液产生的原因和预防[J].国际外科学杂志, 2006, 33(2): 103-106.
7. Boostrom SY, Throckmorton AD, Boughey JC, et al. Incidence of clinically significant seroma after breast and axillary surgery[J]. J Am Coll Surg, 2009, 208(1): 148-150.
8. 赵晨阳, 刘景贞, 马保海, 等.不同游离方法在乳腺癌改良根治术后皮瓣坏死的临床研究[J].临床合理用药杂志, 2013, 6(26): 22-23.
9. 董传江, 尚健, 孙井军, 等.手术刀与电刀游离皮瓣防治乳腺癌术后皮下积液的临床对比分析[J].中国当代医药, 2013, 20(17): 59-60, 62.
10. 董龙庆, 于栋梁, 徐龙君.乳腺癌术后皮下积液与皮瓣坏死的防治[J].临床医学, 2012, 32(12): 18-20.
11. 张彦收, 焦俊琴, 卞晓丽, 等.可吸收止血海绵在乳腺癌改良根治术中应用的效果观察[J].临床外科杂志, 2012, 20(4): 250-251.
12. 张世军, 马红英.乳腺癌术后2种引流方式的疗效比较[J].肿瘤基础与临床, 2011, 24(6): 530-531.
13. 阳旭.不同引流方式对乳腺癌术后皮下积液的作用分析[J].亚太传统医药, 2012, 8(4): 131-132.
14. 宋杏丽, 王钢.单管或双管引流对乳腺癌改良根治术后皮下积液影响的研究[J].中国现代医药杂志, 2013, 15(1): 49-50.
15. 鲁武伟, 彭杏芳.不同处理方法防治乳腺癌术后皮下积液的临床效果观察[J].中国伤残医学, 2013, 21(2): 80-81.
16. 林小燕, 苟菊香, 蒋义雪.乳腺癌病人术后拔管指征的探讨[J].护理研究, 2013, 27(27): 2999-3000.
17. 赵凯华, 胡亦钦, 俞乔, 等.乳腺癌术后皮下积液的影响因素探讨[J].中国肿瘤外科杂志, 2011, 3(1): 17-19.
18. 金科, 章远江, 许健, 等. B超引导静脉留置针持续引流在处理乳腺癌术后局部皮下积液中的应用[J].中国普外基础与临床杂志, 2013, 20(4): 444-446.
19. 张巨合, 徐皓.生物蛋白胶防治乳腺癌术后皮下积液的研究[J].中华全科医学, 2012, 10(7): 1066-1067, 1146.
20. 马榕, 张凯.乳腺癌术后皮下积液的性质及处理原则[J].国际外科学杂志, 2007, 34(7): 501-502.
21. 杜尖, 田茂新, 吴建平, 等.乳腺癌术后皮下积液的防治[J].中国现代医学杂志, 2007, 17(6): 739-740, 743.
22. 吴涛, 张华兵, 曹阿丹.凝血酶在胸膜粘连术中的临床疗效评价[J].中国现代药物应用, 2012, 6(6): 79-80.
23. 马少林, 李润浦, 王艳丽, 等.博莱霉素联合白介素-2及凝血酶治疗恶性胸腔积液的临床观察[J].现代肿瘤医学, 2013, 21(3): 557-559.
24. 吕章春, 胡谷冰, 朱佩贞.博来霉素联合凝血酶对恶性血性胸水的疗效观察[J].肿瘤防治研究, 2002, 29(3): 236-237.
25. 周学敏, 朱铁年, 金普乐, 等.凝血酶治疗癌性胸腔积液的临床观察[J].中华结核和呼吸杂志, 1996, 19(4): 50.

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CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Curative Effect Observation of Thrombin in Treatment of Subcutaneous Effusion Following Radical Resection of Breast Cancer

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