螺旋CT血管造影在腹壁下动脉穿支皮瓣乳房再造术前评价中的应用  

Application of MDCT angiography for breast reconstruction with deep inferior epigastric artery perforator flaps

作　　者：辛敏强[1] 穆兰花[1] 栾杰[1] 穆大力[1] 苏韦祯[1] 

机构地区：[1]中国医学科学院北京协和医学院整形外科医院乳房整形再造中心,北京100144

出　　处：《中华整形外科杂志》2010年第5期351-353,共3页Chinese Journal of Plastic Surgery

摘　　要：目的评价多层螺旋CT（muhidetector—row computed tomography，MDCT）血管造影对腹部穿支皮瓣乳房再造术前血管评估的意义。方法2006年12月至2009年6月，利用MDCT血管造影对34例乳房再造患者行术前腹部穿支血管探测，根据探测结果拟定乳房再造的手术方式，并作术中实际情况和术前探测的对比。选取该时间段之前未行螺旋CT血管造影的22例腹部游离皮瓣乳房再造的病例设立对照组，比较两组间手术方式改变率，手术时间差异，以及术后皮瓣坏死的发生率。结果实验组术前手术方式改变率为23．53％，对照组为0（P=0．00），实验组术中手术方式改变率为0，对照组为13．64％（P=0．00）；实验组切取皮瓣的平均手术时间为（2．51±0．64）h，对照组为（4．42±0．21）h（P〈0．05）。实验组皮瓣并发症发率为6．12％，对照组为12．5％（P=0．017）。结论MDCT是一种准确、简便的方法，有助于更合理地制定乳房再造的手术方式，节约手术时间，降低手术风险。Objective To investigate the significance of preoperative MDCT angiography for breast reconstruction with abdominal flap. Methods Preoperative MDCT angiography scans were performed on 34 patients who underwent breast reconstruction with abdominal flaps during December 2006 to June 2009. The operation was designed based on the MDCT results. Then the MDCT results were proved intraoperatively. Another 22 cases who underwent breast reconstruction with abdominal flap without preoperative MDCT were selected as controls. The rate of operative method change, the operation time and the flap necrosis were compared between the two groups. Results The preoperative design changed in 23.53% of the patients, based on the MDCT results. No one had any method change intraoperatively in the group with MDCT. The operative method was changed intraoperatively in 13.64% of the patients in the control group. The mean time spending on flap harvesting was （2. 51 ±0. 64） h in the experimental group and （4.42 ±0.21） b in the controlled group（P 〈0.05）. The rate of complication was 6. 12% in the experimental group and 12.5% in the control group （ P = 0. 017 ）. Conclusions Preoperative MDCT angiography is an easy and reliable method for breast reconstruction with abdominal flap. The preoperative design can be more reasonable. It helps to save the operation time and reduce the risk.

关 键 词：血管造影术 乳房成形术 外科皮瓣 

分 类 号：R816.2[医药卫生—放射医学] R655.8[医药卫生—临床医学]