扩张后假体置入乳房再造-外科学(整形)专业论文.docxVIP

1 目 录 中文摘要……………………………………………………………………………3 英文摘要……………………………………………………………………………4 前 言……………………………………………………………………………5 材料与方法…………………………………………………………………………7 结 果……………………………………………………………………………12 讨 论……………………………………………………………………………16 结 论……………………………………………………………………………21 参考文献……………………………………………………………………………22 致 谢……………………………………………………………………………25 综 述……………………………………………………………………………26 2 扩张后假体置入乳房再造 摘要 目的 探讨皮肤软组织扩张后假体置入乳房再造在乳腺癌术后乳房缺损及乳房不 对称畸形患者乳房再造中的临床应用。方法 一期手术在肿胀麻醉基础上用乳房 剥离器钝性分离胸大肌后间隙，范围如术前设计大小，将 250-350ml 容积的圆形 皮肤软组织扩张器置于胸大肌深面，术中依据扩张器大小注水 150-200ml，术后 定期注水，依据对侧乳房体积超量注水 25%-74%，维持 3 个月以上。二期手术时 取出扩张器，置入合适容积的乳房假体，尽量达到双侧乳房形态的对称。结果 2010 年以来，采用扩张后假体置入乳房再造术 13 例，已完成二期手术 12 例。 经过 1 月-4 年的随访，12 侧再造乳房外形较满意，大小、位置与健侧乳房基本 一致。 结论 本法再造乳房大小合适，形态自然，位置对称，无附加供区，不增 加额外瘢痕，操作简单，是一种较为理想的乳房再造术。该手术方法通过将来更 长期的临床实践应用和随访观察，有望得到进一步肯定和推广应用。 【关键词】扩张器，乳房再造，乳房假体 3 Breast Reconstruction with A Subpectoral Silicone Tissue Expander Abstract Objects To investigate the application of breast reconstruction that permits the surgeon to expand and recruit sufficient tissue for modified radical mastectomy and asymmetry deformity. Methods A round tissue expander with the capacity of 250-300ml filled with 150-200ml water according to the capacity was placed in subpectoral position during the primary operation. Overexpansion of tissue expander by water injection to match over 25%-74% of the opposite breast was done in the next 3 months. The tissue expander was replaced with permanent implant in the secondary operation. Results A group of 13 cases had been tested and 12 surgery among which have been completed. In addition to 1 cases of the expander was removed of infection after the primary operation to no further treatment，all cases were ended up with satisfaction of 1month to 2 years follow-up since 2010. Conclusions The breast reconstruction with a subpectoral silicone tissue expander is an ideal treatment for modified radical mastectomy and asymmetry deformity. Women can obtain a restored breast approximate to a full opposite breast