单蒂横行腹直肌肌皮瓣和腹部游离皮瓣单侧乳房重建术后满意度比较研究.docVIP

单蒂横行腹直肌肌皮瓣和腹部游离皮瓣单侧乳房重建术后满意度比较研究 　　[摘要]目的 比较单蒂横行腹直肌肌皮瓣和腹部游离皮瓣重建术后乳腺癌患者满意度。 方法 收集2011年9月～2015年10月采用单侧带蒂TRAM或游离腹部皮瓣并完成BREAST-Q的单侧乳房重建术患者的一般资料和临床数据。采用BREAST-Q评定比较乳房满意度、手术满意度、胸部和腹部健康状况。 结果 带蒂TRAM皮瓣重建患者乳房满意度得分高于游离腹部皮瓣重建患者，差异有统计学意义（P=0.02）。术后0.05）。 结论 行单侧带蒂TRAM皮瓣乳房重建的患者较单侧游离腹部皮瓣重建者乳房初始满意度更好，但两种重建术的长期满意度无差异。 　　[关键词] 乳房重建术；患者满意度；肌皮瓣；游离皮瓣 　　[中图分类号] R737.9 [文献标识码] A [文章编号] 1673-9701（2016）19-0013-04 　　[Abstract] Objective To compare the satisfaction of patients after unilateral breast reconstruction by unipedicled transverse rectus abdominis myocutaneous （TRAM） flap and abdominal free flap. Methods General material and clinical data of patients who were given unilateral breast reconstruction by unipedicled TRAM flap or abdominal free flap with completed BREAST-Q from September 2011 to October 2015 were selected. BREAST-Q was used to evaluate the satisfaction of patients towards breast reconstruction， operation， and health condition of breast and abdomen. Results The satisfaction of patients towards breast reconstruction was significantly higher in patients who were given unipedicled TRAM flap than in patients with abdominal free flap（P=0.02）. The satisfaction scores in three years after operation showed similar tendency. However， after more than 3 years of operation， there was no significant difference between two groups（P0.05）. Conclusion The initial satisfaction of patients towards breast reconstruction is higher in patients who were given unipedicled TRAM flap than in patients with abdominal free flap， but the long-term satisfaction of patients shows no difference. 　　[Key words] Breast reconstruction； Satisfaction of patients； Myocutaneous flap； Free flap 　　自体组织重建术（autologous tissue reconstruction）是目前乳房重建的首选方法。应用自体组织再造的乳房形态自然、柔软、美学效果持久[1，2]，并且能避免假体置入后的远期并发症。腹部作为皮瓣供区具有组织量大，手术时间短，血供丰富，可同时进行腹壁整形，供区可直接拉拢缝合等诸多优点。带蒂TRAM皮瓣（pedicled transverse rectus abdominis myocutaneous flap， pedicled TRAM flap）和游离腹部皮瓣（free abdominal flap）目前临床应用较多，本研究采用乳房重建术后生活质量测定量表（BREAST-Questionnaire，