乳腺癌改良根治术后一期乳房再造术中应用背阔肌肌皮瓣价值.docVIP

乳腺癌改良根治术后一期乳房再造术中应用背阔肌肌皮瓣的价值 　　【摘要】目的探讨在乳腺癌改良根治术后一期乳房再造术中应用背阔肌肌皮瓣的安全性及可行性。方法选取2012年10月至2016年10月收治的乳腺癌患者90 例，将其随机分为两组，各45 例。对照组单用乳腺癌改良根治术，观察组术后行一期背阔肌肌皮瓣乳房再造术。评估观察组乳房美容效果，比较两组术后恢复情况、并发症发生率。结果观察组乳房美容优良率为95.56%，对照组患侧乳房完全缺失。两组术后恢复情况及并发症发生率相近，差异无统计学意义（P0.05）。结论在乳腺癌改良根治术后一期乳房再造术中应用背阔肌肌皮瓣安全可行，操作相对简单，乳房美容效果较佳。 　　【关键词】乳腺癌改良根治术；背阔肌肌皮瓣；乳房再造 　　中图分类号：R737.9 文献标识码：ADOI：10.3969/j.issn.1003-1383.2017.04.022 　　【Abstract】ObjectiveTo investigate the safety and feasibility of laissimus dorsi mycoutaneous flap（LDMF）in one-stage breast reconstruction after modified radical mastectomy.Methods90 patients with breast cancer admitted to hospital from October，2012 to October，2016 were randomly divided into control group and observation group with 45 cases in each.The control group were given pure modified radical mastectomy，and based on which the observation group were given one-stage LDMF breast reconstruction.The breast cosmetic effect of the observation group was assessed.And the postoperative recovery and the incidence of complications of two groups were compared.ResultsThe cosmetic excellent rate of breast in the observation group was 95.56%，and the diseased breast completely missed in the control group.The postoperative recovery rate and the incidence of complications of two groups were similar，difference was not statistically significant（P0.05）.ConclusionLDMF in one-stage breast reconstruction after modified radical mastectomy is safe and feasible with easy operation and better breast cosmetic effects. 　　【Key words】modified radical mastectomy；LDMF；breast reconstruction 　　乳腺癌是危害女性健康的常见疾病，近年来发病率逐渐增加，且年轻患者数量不断增多。乳腺癌根治术是治疗乳腺癌的主要手段，但术后易造成乳房缺失、腋窝凹陷、胸壁畸形、姿态变形等问题，使得患者产生生理?c心理上的痛苦[1]。因此，乳腺癌理想的治疗模式是既能够根治肿瘤，亦可保持乳房美观度。乳房再造术为保持相对美观的乳房形态，减轻患者心理负担提供了一个新选择，并逐渐成为乳腺癌治疗过程中重要的一部分[2]。乳腺癌根治术后一期乳房再造目前已逐渐开展于国内临床，本研究分析扩大背阔肌肌皮瓣在乳房再造术中的应用价值，旨在进一步完善乳房再造效果，现报告如下。 　　1资料与方法 　　1.1一般资料选择2012年10月至2016年10月我院收治的乳腺癌患者90 例，将所有患者随机分为两组，每组45 例。观察组年龄34～50岁，平均（42.73±4.21）岁；临床分期：Ⅰ期24 例、Ⅱa期12 例、Ⅱb期9 例。对照组年龄33～50岁，平均（43.6