乳腺肿瘤术后即刻修复与重建的临床研究  

Immediate Breast Reconstruction after Surgical Treatment for Breast Tumor

作　　者：穆兰花[1] 栾杰[1] 李魏[1] 郑一华[1] 穆大力[1] 刘晨[1] 王凌宇[1] 牛兆河[1] 王盛[1] 尤建军[1] 张保宁[2] 宣立学[2] 荣永婴[3] 王先明[4] 赵春英[5] 李贵轩 

机构地区：[1]中国医学科学院中国协和医科大学整形外科医院 [2]中国医学科学院中国协和医科大学肿瘤医院乳腺中心,100021 [3]北京市通州区潞河医院乳腺中心,101149 [4]广东省深圳市第二人民医院普外科,518027 [5]上海中医药大学曙光医院乳腺中心,20013 [6]辽宁省营口市中心医院肿瘤外科,115003

出　　处：《临床肿瘤学杂志》2006年第2期87-90,共4页Chinese Clinical Oncology

基　　金：教育部回国留学人员科研启动基金资助项目;中国临床肿瘤学科学基金(CSCO-康莱特基金)资助项目(Y-2004-0004)

摘　　要：目的：减少女性乳腺肿瘤术后局部畸形，提高患者生活质量。方法：2003年以来，我们多中心课题组通力合作，对23例乳腺肿瘤患者进行术后即刻修复与再造（其中良性肿瘤6例，囊性肉瘤1例，乳腺癌16例），分别采用水平双蒂巨乳缩小方法、背阔肌肌皮瓣带蒂转移、乳房假体植入、横形腹直肌肌皮瓣带蒂转移、腹壁下动脉穿支皮瓣吻合血管游离移植。手术前后进行心理问卷调查；比较住院时间及费用；观察对辅助治疗及复发的影响。结果：23例患者分别采用不同方法修复，除1例术后吻合口出现静脉栓塞外，余皮瓣全部成活，形态满意。随访2～18个月，无腹部薄弱或腹壁疝等并发症；患者术后显示较强的自信，恢复正常学习和工作。结论：乳腺肿瘤术后即刻修复与再造是一种安全可行的方法。适应症为良性乳腺肿瘤及有强烈乳房再造要求的Ⅰ、Ⅱ期乳腺癌患者；Ⅲ期以上乳腺癌患者，可权衡病人的全身状况，不是绝对禁忌症。应根据患者具体情况选择适合患者本人的方法进行乳房再造。Objective：To modify the local deformity, to decrease psychological disease and improve life quality of the female patient after surgical treatment for breast tumor. Methods：Since 2003,23 cases immediate breast reconstructions were finished with different methods, such as de-epidermis pedicled lattismus myocutaneous flap, pedicled lattismus myocutaneous flap （one case with breast prosthesis）, pedicled TRAM （ transvers abdominal myocutaneous flap） and free DIEP （deep inferior epigastric perforator flap）. Psychological questions were asked pre-and post-operation. Hospitalized time and fee were compared. Effection to adjust treatment were pay attention. Results：The follow-up time was 2 - 18 months. Except 1 flap failed due to vein thrombosis post anastomosis, all other flaps survived completely with satisfied shape. No recurrent cases were found. The following adjuvant treatment were not postponed. Conclusion ：Immediate breast reconstruction after surgical breast treatment is safe and effective, It can treat patient both on body and psychologically. The adjust treatment were not postponed. Fee was low and shape was better. The indications were patients with benign tumor and breast cancer in clinical stage Ⅰ-Ⅱ. Stage Ⅲ were not controindication. Suitable method should be choosen for different patients.

关 键 词：乳腺肿瘤 手术 即刻修复与重建 

分 类 号：R737.9[医药卫生—肿瘤]