【摘要】 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。更多还原

【Abstract】 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.更多还原