乳房再造76例  

Breast Reconstruction of 76 Patients

作　　者：刘晨[1] 栾杰[1] 穆兰花[1] 穆大力[1] 郑一华[1] 王凌宇[1] 李巍[1] 

机构地区：[1]中国协和医科大学整形外科医院乳房整形美容中心,100041

出　　处：《整形再造外科杂志》2006年第2期67-70,共4页

摘　　要：目的探讨应用各种自体组织移植和人工材料置入的方法再造乳房的适应证与优缺点。方法分别应用下腹部腹直肌(TRAM)与腹壁下动脉穿支(DIEP)联合皮瓣、双侧DIEP皮瓣、单侧DIEP皮瓣、TRAM皮瓣、扩大背阔肌肌皮瓣、背阔肌带蒂移植与硅凝胶假体置入联合应用、硅凝胶假体置入等方法再造乳房76例,按手术方法分类,并对手术效果、并发症进行分析和评估。结果76例乳房再造患者中,有67例患者应用了合计70侧自体组织移植皮瓣,90%的移植皮瓣完全成活,4侧(5.7%)出现皮瓣远端局部脂肪硬结,3侧(4.3%)皮瓣因血管吻合口栓塞而完全失活。再造乳房与健侧基本对称,形态自然,绝大多数再造乳房的形态优于健侧乳房。结论要充分考虑各种乳房再造手术方法的适应证,针对患者的具体情况选择不同的再造方法,最终可重建出左右对称、形态完美、富有魁力的乳房。Objective To evaluate the indication,advantage and disadvantage of the breast reconstruction with the autologous tissue and/or prosthesis.Methods The 76 breasts were reconstructed with the TRAM and DIEP united flap,the bilateral DIEP flap,the unilateral DIEP flap,the TRAM flap,the extended latissimus dorsi flap,the latissimus dorsi flap affiliated with the prosthesis,and only the prosthesis,respectively.The operative results and complications were analyzed and assessed according to the operative methods.Results Of the 76 cases,67 cases involved 70 autologeolis tissue flaps.The 90% flaps survived completely,and there were a few adipose indurations in the most proximal portion of the 5.7% flaps.Three flap devitalized because of the embolism of vessels anastomotiC stoma.The reconstructed breasts were symmetrical with the controlateral ones visually,and their appearances seem natural and fascinating.Conclusions It is important to think about the indication of the breast reconstruction methods.The methods should be selected according to the actual condition of the cases,and the charming breast would be reconstructed ultimately.

关 键 词：扩大背阔肌肌皮瓣 再造乳房 自体组织移植 手术方法 探讨应用 乳房再造 假体置入 形态 适应证 患者 硅凝胶 血管吻合口 手术效果 人工材料 联合应用 联合皮瓣 方法分类 动脉穿支 带蒂移植 下腹部 

分 类 号：R[医药卫生]