乳腺癌术后乳房延迟即刻重建临床效果分析:附100例报告  

Clinical effect of delayed-immediate reconstruction after radical mastectomy:a report of 100 cases

作　　者：张海林[1] 茅枫[2] 王学晶[2] 白明[1] 王晓军[1] 

机构地区：[1]中国医学科学院北京协和医院整形外科,北京100730 [2]中国医学科学院北京协和医院乳腺外科,北京100730

出　　处：《中国普通外科杂志》2015年第5期653-657,共5页China Journal of General Surgery

摘　　要：目的:探讨乳腺癌术后乳房延迟即刻重建术的安全性和有效性。方法:随机抽取2010年10月—2013年10月间100例乳腺癌改良根治术后行乳房延迟即刻重建术患者资料进行回顾性分析。100例患者的重建术中,背阔肌肌皮瓣转移皮肤扩张器植入法(LD+扩张器)39例,胸大肌联合异体真皮下植入皮肤扩张器法(ADM+扩张器)6例,直接植入胸部皮瓣下的扩张器法55例。结果:全组术后主、客观满意率均为92.0%。术后主、客观满意度优良率LD+扩张器法患者为84.6%、89.7%,扩张器直接植入患者为60%、65.5%,ADM+假体扩张器法患者均为100.0%。统计分析显示(ADM+扩张器法因病例数较少,未纳入比较),LD+扩张器法患者的主观、客观满意度均高于扩张器直接植入法(均P<0.05)。结论:乳腺癌术后乳房延迟即刻重建术采用LD+扩张器法的患者满意度高且成本低于ADM+假体扩张器,建议首选。Objective：To evaluate the safety and ef ectiveness of delayed-immediate breast reconstruction after radical mastectomy.Methods：The clinical data of 100 randomly selected patients undergoing delayed-immediate breast reconstruction after modiifed radical mastectomy from October 2010 to October 2013 were retrospectively analyzed.In the reconstruction methods among the 100 patients,latissimus dorsifmusculocutaneous flap plus expander implant（LD＋expander） was performed in 39 cases,pectoralis major muscle combined with acellular dermal matrix plus expander implant（ADM＋expander） was performed in 6 cases,and direct expander implantwas performed in 55 cases.Results：In the entire group,both subjective and objective satisfactory rates were 92.0%.The excellent and good rate of postoperative subjective and objective satisfaction in patients undergoing LD＋expander implant was 84.6% and 89.7%,was 60% and 65.5% in patients undergoing direct expander implant,and was both 100.0% in patients undergoing ADM＋expander implant,respectively.Statistical analysis showed（those undergoing ADM＋expander implant were not included due to the small number of cases） that both degrees in subjective and objective satisfaction in patients undergoing LD＋expander implant were higher than those in patients receiving direct expander implant（both P0.05）.Conclusion：Using LD＋expander implant for delayed-immediate breast reconstruction after radical mastectomy offers a better patients＇ satisfaction,with less cost than that of ADM＋expander implant,so it is recommended as ifrst option.

关 键 词：乳腺肿瘤 乳房切除术 改良根治性 修复外科手术 

分 类 号：R737.9[医药卫生—肿瘤]