硅凝胶假体植入乳房重建  

Immediate breast construction with silicone prosthesis after nipple-areola complex sparing mastectomy

作　　者：何益腾 宋牧[1] 陈晶[1] 于冰[1] 朱丽萍[2] 

机构地区：[1]新疆医科大学第二附属医院,新疆维吾尔自治区乌鲁木齐市830063 [2]新疆医科大学附属肿瘤医院,新疆维吾尔自治区乌鲁木齐市830011

出　　处：《中国组织工程研究》2015年第3期455-459,共5页Chinese Journal of Tissue Engineering Research

摘　　要：背景:中国女性乳腺体积相对偏小,乳腺癌传统保乳手术后乳腺外形欠佳,而采用背阔肌肌皮瓣和横行腹直肌肌皮瓣乳房再造手术难度高、创伤大、术后并发症多,因此行保留乳头乳晕复合体Ⅰ期硅凝胶假体植入乳房重建手术是非常好的选择。目的:探讨保留乳头乳晕复合体乳腺癌改良根治术后Ⅰ期硅胶假体植入乳房重建的效果。方法:纳入女性乳腺癌患者33例,年龄30-48岁,左侧20例,右侧13例,均于保留乳头乳晕复合体乳腺癌改良根治术后行Ⅰ期硅凝胶假体植入乳房重建治疗,术后通过随访行主客观评价美容效果。结果与结论:33例患者中,术后乳头乳晕复合体坏死2例,自行结痂愈合;1例术中出血量>800 m L,经补液、输血治疗后,恢复良好。随访10-51个月,31例乳房外观良好,双侧乳房对称,优良率达94%,均未发现局部复发及远处转移。证实保留乳头乳晕复合体乳腺癌改良根治术后行硅胶假体Ⅰ期乳房重建,美容效果满意,无严重并发症,手术安全,简单可行。BACKGROUND：As Chinese women have the smaler breast capacity, the traditional breast conserving operation may lead to the poor breast shape, moreover, breast reconstruction with latissimus dorsi myocutaneous flap and transverse rectus abdominis myocutaneous flap is very difficult and has trauma and more complications. Therefore, the immediate breast construction with implants after nipple-areola complex sparing mastectomy is a good choice. OBJECTIVE： To investigate the feasibility of immediate breast construction using silicone prosthesis after nipple-areola complex sparing mastectomy. METHODS：The immediate breast reconstruction after nipple-areola complex sparing mastectomy was performed in 33 female patients with breast cancer （20 cases in the left side and 13 cases in the right side）, aged 30-48 years. The effects of reconstructed breast were evaluated according to objective and subjective criteria during the folow-up. RESULTS AND CONCLUSION：Of the 33 cases, 2 cases had nipple-areola complex ischemic necrosis postoperatively and were cured quickly; 1 case had intra-operative blood loss 〉 800 mL and recovered wel after fluid and blood transfusion. The aesthetic outcome was wel in 31 cases and the satisfactory rate was 94% during 10-51 months of folow-up period. No recurrence and metastasis were found in al cases. The operation method of＆amp;nbsp;immediate breast reconstruction with implants after nipple-areola complex sparing mastectomy is maneuverable and has excelent aesthetic effects with no severe complications.

关 键 词：生物材料 材料相容性 硅凝胶 假体 乳腺癌 保留乳头乳晕复合体 乳房重建 Ⅰ期手术 

分 类 号：R318[医药卫生—生物医学工程]