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目的:探讨乳腺癌术中切开前皮下注射药物的止血效果。方法:38例拟在全麻下行乳腺癌单纯切除或改良根治术的患者前瞻性动态随机分2组:⑴注药组,0.1%盐酸肾上腺素注射液1 mL+2%盐酸利多卡因注射液30 mL+0.9%氯化钠注射液500 mL配比,在手术范围内皮下注射。⑵对照组,术前不注射药物,手术方法同注药组。比较两组术中心率、血压、术中出血量、手术时间、术后引流量、术前、术后第1,3,5天血红蛋白含量,伤口引流管拔除时间,拔管后皮下积液、皮瓣坏死情况。结果:注药组的心率、血压在手术中没有增快,反而降低,可能与全麻和利多卡因的作用有关。手术出血量注药组较对照组少(P<0.05)。伤口引流管拔除时间及拔管后皮瓣下积液情况,两组比较均没有统计学差异(P>0.05)。两组伤口引流量无统计学差异(P>0.05),术前、术后第1,3,5天血红蛋白含量变化比较两组无统计学差异(P>0.05)。结论:乳腺癌术前皮下注射药物止血方法是安全的,能够减少出血,并不影响心率、血压、术后引流量、引流管拔除时间、皮下积液、血红蛋白的含量,所以该方法是有一定临床应用价值的。
Objective: To investigate the hemostatic effect of subcutaneous injection before breast incision in operation. METHODS: A total of 38 patients undergoing radical resection or modified radical mastectomy under general anesthesia were prospectively randomized into 2 groups: (1) injection group, 0.1% epinephrine hydrochloride injection 1 mL + 2% lidocaine hydrochloride injection 30 mL+0.9% Sodium Chloride Injection 500 mL was injected subcutaneously into the surgical range. (2) In the control group, no drugs were injected before surgery, and the surgical method was the same as the injection group. The center rate, blood pressure, intraoperative blood loss, operative time, postoperative drainage volume, hemoglobin content on the first, third and fifth days after operation, wound removal time, and subcutaneous effusion after extubation were compared between the two groups. Flap necrosis. RESULTS: The heart rate and blood pressure of the injection group did not increase during surgery, but decreased, which may be related to the effects of general anesthesia and lidocaine. The amount of blood loss in the injection group was less than that in the control group (P<0.05). There was no significant difference between the two groups in the time of removal of the wound drainage tube and the effusion under the flap after extubation (P>0.05). There was no significant difference in the volume of wound drainage between the two groups (P>0.05), and there was no significant difference between the two groups before and after the first, third and fifth days of hemoglobin levels (P>0.05). Conclusion: The method of hemostasis by subcutaneous injection before breast cancer is safe, can reduce bleeding, does not affect the heart rate, blood pressure, postoperative drainage, drainage tube removal time, subcutaneous fluid, hemoglobin content, so this method is certain Clinical application value.