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中华普外科手术学杂志(电子版) ›› 2018, Vol. 12 ›› Issue (05) : 400 -403. doi: 10.3877/cma.j.issn.1674-3946.2018.05.014

所属专题: 文献

论著

乳腺外科术后切口感染对凝血纤溶功能及淋巴水肿的影响
梁云1, 郭仁妃1,(), 曾晶1, 林鸿旺1, 薛丽2   
  1. 1. 570203 海南省海口市妇幼保健院
    2. 571199 海南医学院附属第一医院肿瘤科
  • 收稿日期:2018-01-23 出版日期:2018-10-26
  • 通信作者: 郭仁妃

Influence of incision infection on coagulation and fibrinolysis and lymphedema after breast surgery

Yun Liang1, Renfei Guo1,(), Jing Zeng1, Hongwang Lin1, Li Xue2   

  1. 1. Haikou maternal and child health hospital, Hainan 570203, China
    2. Department of oncology, the first affiliated hospital of Hainan medical college, Hainan 571199
  • Received:2018-01-23 Published:2018-10-26
  • Corresponding author: Renfei Guo
  • About author:
    Corresponding author: Guo Renfei, Email:
  • Supported by:
    National Natural Science Foundation of China(NO.30760282)
引用本文:

梁云, 郭仁妃, 曾晶, 林鸿旺, 薛丽. 乳腺外科术后切口感染对凝血纤溶功能及淋巴水肿的影响[J/OL]. 中华普外科手术学杂志(电子版), 2018, 12(05): 400-403.

Yun Liang, Renfei Guo, Jing Zeng, Hongwang Lin, Li Xue. Influence of incision infection on coagulation and fibrinolysis and lymphedema after breast surgery[J/OL]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2018, 12(05): 400-403.

目的

探讨乳腺外科术后切口感染对凝血纤溶功能及淋巴水肿的影响。

方法

回顾性分析2016年1月至2018年5月行乳腺癌根治术患者86例资料,以术后切口感染患者34例为感染组,切口未感染患者52例为未感染组。采用SPSS21.0统计学软件进行数据分析,凝血纤溶功能指标、上肢淋巴水肿发生时间、血小板参数指标及血清细胞因子水平等以均数±标准差表示,独立t检验。上肢淋巴水肿发生率用χ2检验,P<0.05为差异有统计学意义。

结果

感染组凝血酶原时间(PT)、活化部分凝血酶时间(APTT)显著低于未感染组,D-二聚体(D-D)及纤维蛋白原(FIB)显著高于未感染组(P<0.05)。感染组上肢淋巴水肿发生率显著高于未感染组,发生时间显著短于未感染组(P<0.05)。感染组血小板压积(PCT) 、血小板分布宽度(PDW)及平均血小板体积(MPV)显著高于未感染组(P<0.05)。感染组IL-4、IL-6、IL-10、TNF-α及IFN-γ水平显著高于未感染组,IL-2水平显著低于未感染组,差异均具有统计学意义(P<0.05)。

结论

乳腺癌根治术后感染可导致机体炎性因子水平的升高,纤溶功能及血小板参数的异常,与患者发生上肢淋巴水肿关系密切。

Objective

To investigate the influence of incision infection on coagulation and fibrinolysis and lymphedema after breast surgery.

Methods

From January 2016 to May 2018, clinical data of 86 patients underwent radical mastectomy were retrospectively analyzed. 34 patients with postoperative incision infection were divided into observation group and 52 patients with postoperative incision uninfected into control group. Statistical analysis were performed by using SPSS21.0 software. The indexes of coagulation and fibrinolysis, the time of occurrence of upper limb lymphedema, the parameters of platelet and the level of serum cytokines were expressed as mean±standard deviation and were examined by independent t test. The incidence of upper limb lymphedema was examined by χ2 test (P<0.05).

Results

The time of PT、APTT in infection group were significantly lower than those in the uninfected group, the level of D-D and FIB were significantly higher than those of non-infected group, with significant difference (P<0. 05). The incidence of upper limb lymphedema in infected group was significantly higher than that in uninfected group. The time of upper limb lymphedema was significantly shorter than that in uninfected group (P<0.05). The level of PDW、MPV and PCT in infected group were significantly higher than those in uninfected group (P<0. 05). The levels of IL-4, IL-6, IL-10, TNF-α and IFN-γ in infected group were significantly higher than those in uninfected group (P<0.05).

Conclusion

Incision infection after radical mastectomy could lead to elevated levels of inflammatory factors, fibrinolysis and abnormal platelet parameters, which are closely correlated to the incidence of upper limb lymphedema of patients.

表1 86例乳腺癌根治术后感染与否两组凝血纤溶功能的比较(±s)
表2 86例乳腺癌根治术后感染与否两组血小板参数的比较(±s)
表3 86例乳腺癌根治术后感染与否两组血清细胞因子水平的比较(±s)
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