Clinical Study On The Influential Factors Of Drainage Time After Surgery Of Breast Cancer

Background:Breast cancer is currently a major threat to women health. The incidence of breast cancer has a clear upward trend.Currently, breast cancer has ranked the first in a variety of malignant tumors of the women in some major cities. Surgery is still the main method for the treatment of breast cancer. Modified radical mastectomy and radical mastectomy,as the most common surgical methods for the treatment of breast cancer, have saved the lives of countless patients with breast cancer. The surgical methods need to clean axillary lymph nodes,small blood vessels and lymphatic vessels. Combined with many preoperative, intraoperative and postoperative factors, there are large surgical wound and much oozing liquid, which easily lead to the occurrence of subcutaneous and axillary dead space, effusion, infection, necrosis. The complications affect the healing time and the drainage time, resulting in the length of stay being prolonged and further treatment being delayed.Objective:The purpose of the clinical study is to explore the possible influential factors that can prolong the drainage time after surgery of breast cancer. The factors include age, body mass index (BMI), surgery approach, levels of lymph nodes dissection,diabetes mellitus (DM), hypertension and anticoagulation therapy. It will provide a reference to the clinical work if the factors are certain.Methods:A total of435patients diagnosed as breast cancer by pathology is analyzed, which is acquired in the department of breast surgery of Qilu Hospital, Shandong University from January2012to December2012. By reviewing the clinical cases,the information of age,BMI, surgery approach, levels of lymph nodes dissection, DM hypertension and anticoagulation therapy are acquired. And BMI (kg/m2)=weight (kg)/height2(m2). Two inclosed drainage tubes are placed parasternum and under the arm separately to drain the effusion and hemorrhage. And the incision is bandaged with sterile pads and a chest strap. Observe and record the postoperative drainage volume and the drainage time(The extubation indication:continuous drainage volume≤15ml/24h for at least two days, and there is no subcutaneous seroma). The data are recorded by Microsoft Excel and analysised by SPSS16.0and SAS9.1.3.Results:1.Non-old group (<60years)and old group (≥60years) have statistic difference in the discrepancy of drainage time (t=2.917, P=0.004). The average drainage time of non-old group(9.22days) is shorter than old group(10.84days).2.Non-overweight group (BMI≤24kg/m2) and overweight group (BMI>24kg/m2) have significant statistic difference in the discrepancy of drainage time (t=-4.685, P<0.001). The average drainage time of non-overweight group (8.49days) is shorter than overweight group (10.54days).3. Group of modified radical mastectomy (MRM) and group of radical mastectomy (RM) have no statistic difference in the discrepancy of drainage time (t=-1.263,P=0.207).4.Dissection of2levels (level Ⅰ and level Ⅱ) of axillary lymph nodes and3levels of axillary lymph nodes (level Ⅰ、 Ⅱ、Ⅲ) have no statistic difference in the discrepancy of drainage time (t=9.30, P=0.353).5.DM group and non-DM group have significant statistic difference in the discrepancy of drainage time (t=2.669,P=0.008). The average drainage time of DM group(11.44days) is longer than non-DM group(9.36days).6.Hypertension group and non-hypertension group have statistic difference in the discrepancy of drainage time (t=2.083, P=0.038). The average drainage time of hypertension group (10.55days) is longer than non-hypertension group (9.33days).7.Anticoagulation therapy group and non-anticoagulation therapy group have no statistic difference in the discrepancy of drainage time (t=0.117,P=0.907).8.Age and BMI can enter into the multiple linear regression equation. Conclusion:1. Age, BMI, DM and hypertension are important influential factors of drainage time after surgery of breast cancer.2.Surgery approach, levels of lymph node dissection and anticoagulation therapy are not the important influential factors of drainage time after surgery of breast cancer.3. We can predict the drainage time from the four factors of the age, BMI, DM and hypertension in patients after surgery of breast cancer. In other words,we can shorten the drainage time by reducing BMI,controlling blood glucose and stabilizing blood pressure.