保留少量腹直肌的游离TRAM皮瓣和DIEP皮瓣乳房再造并发症的Meta分析  

Complications of breast reconstruction with MS-Free TRAM and DIEP:a Meta-Analysis

作　　者：杨明[1] 谭谦[2] 

机构地区：[1]东南大学医学院,江苏南京210009 [2]南京大学医学院附属鼓楼医院整形烧伤科,江苏南京210008

出　　处：《东南大学学报（医学版）》2012年第6期711-720,共10页Journal of Southeast University(Medical Science Edition)

摘　　要：目的:比较保留少量腹直肌的游离TRAM皮瓣(MS-Free TRAM)和腹壁下动脉穿支皮瓣(DIEP)乳房再造术的并发症发生率,为临床决策提供依据。方法:在Medline数据库、中国生物医学数据库、维普生物数据库、Cochrane图书馆等检索有关MS-Free TRAM及DIEP乳房再造的文献。按照纳入与排除标准选择文献、提取资料和评价质量后,采用RevMan5.0和R2.15软件进行Meta分析。结果:同时包含MS-Free TRAM和DIEP的研究有7个;MS-Free TRAM和DIEP发生脂肪液化OR值为0.69,95%CI为[0.26,1.78],P=0.44;发生皮瓣部分坏死OR值为0.92,95%CI为[0.38,2.23],P=0.86;发生皮瓣完全坏死OR值为0.35,95%CI为[0.13,0.90],P=0.03;发生腹壁膨隆或疝OR值为2.07,95%CI为[1.15,3.73],P=0.01。结论:与MS-Free TRAM乳房再造相比,DIEP乳房再造的腹壁并发症发生率较低,但皮瓣完全坏死的风险是增加的。To analyze the complications of breast reconstruction with muscle-sparing free transverse rectus abdominis myocutaneous flap （MS-Free TRAM ） and deep inferior epigastric perforator flap （DIEP）.Methods： Databases such as Medline, CBM, VIP and Cochrane Library were searched to include articles on breast reconstruction with MS-Free TRAM and DIEP flap. Meta analyses were performed by RevMan 5.0 and R 2.15 software after the data were abstracted and the quality was evaluated. Results： Seven studies reporting outcomes of MS-Free TRAM and DIEP flap were used to estimate odds ratios of complications and confidence intervals. MS-Free TRAM group and DIEP group occurred the risk of fat necrosis combined OR = 0.69, 95% CI was [ 0.26, 1.78 ], P = 0.44, occurred the risk of partial flap loss combined OR = 0.92, 95 % CI was [ 0.38,2.23 ], P =O. 86, occurred the risk of total flap loss combined OR =0.35,95% CI was[O. 13,0.90] ,P =0.03, occurred the risk of abdominal bulge or hernia combined OR = 2.07,95% CI was [ 1. 15,3.73 ] , P = O. 01. Conclusions：Compared with the MS-Free TRAM flap, reduces abdominal morbidity of breast reconstruction with DIEP flap is lower but the risk of total flap loss is increased.

关 键 词：保留少量腹直肌的游离TRAM皮瓣 腹壁下动脉穿支皮瓣 乳房再造 并发症 META分析 

分 类 号：R622[医药卫生—整形外科]