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目的:探讨高频电刀在乳腺癌手术皮瓣游离中的临床应用及其功率大小对术后皮瓣坏死的影响。方法:回顾性分析2003年1月至2008年9月,在我院154例行乳腺癌改良根治术患者的临床资料,其中乳腺刀组(A组)37例,小功率电刀组(B组)60例,大功率电刀组(C组)57例,对比分析各组皮瓣坏死情况。结果:共发生皮瓣坏死35例,其中A组用乳腺刀游离皮瓣6例(6/37),B组用小功率电刀(18～22W)游离皮瓣9例(9/60),C组用大功率(≥28W)电刀游离皮瓣20例(20/57),B组与A组比较差异无显著意义(P>0.05),C组与A、B组比较差异有显著意义(P<0.05);而B、C组与A组比较,游离皮瓣时出血量明显减少,差异有显著性意义(P<0.05)。结论:合理应用高频电刀游离皮瓣具有术中出血少,术后恢复快的优势,但若功率过高,则会增加皮瓣坏死率。
Objective: To investigate the clinical application of high frequency electrosurgical knife in surgical operation of breast cancer and its effect on postoperative skin flap necrosis. Methods: The clinical data of 154 patients with modified radical mastectomy in our hospital from January 2003 to September 2008 were analyzed retrospectively. Among them, 37 cases were treated by breast knife group (A group), B group ) 60 cases, high power knife group (C group) 57 cases, comparative analysis of each group of flap necrosis. Results: A total of 35 cases of skin flap necrosis occurred in 6 cases (6/37) in group A and 9 cases (9/60) in group B with low-powered knife (18-22W) There were 20 cases (20/57) in group C with free flap (≥28W), there was no significant difference between group B and group A (P> 0.05). There was significant difference between group C and group A and B (P <0.05). Compared with group A, the hemorrhage volume in the free flap was significantly reduced in group B and group C, the difference was significant (P <0.05). Conclusion: The rational application of high frequency electrosurgical free flap has the advantages of less intraoperative bleeding and faster postoperative recovery, but if the power is too high, the flap necrosis rate will increase.