乳腺癌改良根治术后腹壁下动脉穿支皮瓣即刻乳房重建十例  

Free deep inferior epigastric artery perforator flap techniques for the immediate post modified radial mastectomy reconstruction

作　　者：郑敏[1] 林海舵[1] 蒋正财[1] 杨景全[2] 

机构地区：[1]温州医学院附属二院乳腺外科,325027 [2]温州医学院附属二院整形外科,325027

出　　处：《中华医学杂志》2008年第15期1069-1070,共2页National Medical Journal of China

摘　　要：目的探讨早期乳腺癌改良根治术后即刻乳房重建的可行性和方法。方法对Ⅰ期或Ⅱa期乳腺癌患者行保留皮肤的乳腺癌改良根治术后，切取以腹壁下动静脉为血管蒂的游离皮瓣，与患侧胸背动静脉相吻合，行即刻腹壁下动脉穿支皮瓣（DIEP）乳房重建。结果2005年以来，应用DIEP皮瓣重建乳房10例，8例患者重建的乳房全部存活，无任何并发症；1例部分皮瓣坏死；1例局部脂肪液化。随访9—28个月，重建乳房形态正常，未出现供区腹部并发症。患者优良满意率达90％以上。结论DIEP皮瓣乳房重建血运丰富，组织量大，易于塑形，腹部并发症少，远期效果好。Objective To discuss the feasibility and method of immediate breast reconstruction right after modified radical mastectomy in early breast carcinoma patients. Methods Deep inferior epigastric artery perforaton flaps were immediately applied on patients to reconstruct the breast after the skin-sparing mastectomy, The breasts were shaped after the deep inferior epigastric artery and vein were anastomosed to the thoracodorsal artery and vein, Results In 10 cases of breast reconstruction by DIEP flaps since 2005, there were completely survival in 8 flaps, distal skin necrosis in 1 flap, adiponecrosis in 1 flap, With the follow-up of 9-28 months, the reconstructed breasts were well-shaped and there were no abdominal complication in dnor sites, Ninety percent patients were satisfied with the results from the good to the best level, Conclusion Most patients were satisfied with the results of mastectomy reconstruction.

关 键 词：乳腺肿瘤 乳房成形术 外科皮瓣 

分 类 号：R686[医药卫生—骨科学]