腹壁下动脉穿支皮瓣乳房重建患者满意度及并发症的研究.PDF

腹壁下动脉穿支皮瓣乳房重建患者满意度及并发症 的 研究 刘静，孙敬岩，何珊珊， 张学慧，王燕，于洋， 尹健 作者单位：天津医科大学肿瘤医院，国家肿瘤临床医学研究中心；天津市肿瘤防治重点实 验室；乳腺癌防治教育部重点实验室 通信作者：尹健 healthyin@ 第一作者 E-mail: ljmirror@ 摘要 目的：评估乳腺癌术后腹壁下动脉穿支 （DIEP）皮瓣乳房重建患者满意度及相 关因素，分析术后并发症的发生及处理方法。 方法：对 2003 年至 2012 年我院 DIEP 皮瓣乳房重建的 26 例乳腺癌患者进行分 析并随访。 结果：26例 DIEP皮瓣均存活。Michigan乳房重建总体满意度61.9%，美学满意 度66.7%。年龄（P=0.049）、腹部手术史（P=0.027）为影响总体满意度的因素； BMI指数（P=0.049）为影响美学满意度的因素。4例出现静脉淤血，经手术或药 物治疗解除症状，1例局部脂肪坏死，1例皮瓣感染；1例腹肌力量减弱，经功能 锻炼于术后6个月恢复。 结论：DIEP 皮瓣乳房重建外形美观自然，供区并发症发生率较低，在有显微外 科技术条件的单位应积极开展，但其适应症应严格把握。 关键词：腹壁下动脉穿支皮瓣 ; 乳房重建; 并发症; 总体满意度 ; 美学满 意度 A Retrospective Study of Free Deep Inferior Epigastric Perforator Flap Breast Reconstruction after Mastectomy for Breast Cancer Patients LIU Jing, HE Shan-shan, ZHANG Xue-hui, SUN Jing-yan, YU Yang, YIN Jian, Department of Breast Cancer Surgery, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin 300060, China. Key Laboratory of Breast Cancer Prevention and Therapy, Tianjin Medical University, Ministry of Education, Tianjin 300060, China. Correspondence to: YIN Jian Abstract Objectives : Deep inferior epigastric perforator (DIEP) flaps has been the most ideal choice for breast reconstruction until recently as it provide acceptable morbidity and superior esthetic outcome for breast cancer patients. This study evaluated patient satisfaction of DIEP flaps breast reconstruction, identified factors influencing patient satisfaction, and analyzed complications and its management. Methods : Data of 26 consecutive breast cancer patients who underwent DIEP flap breast reconstruction at the Department of Breast Cancer, Tianjin Cancer Hospital from