保留乳头乳晕感觉的乳腺切除术治疗男性乳腺发育的疗效分析  

Efficacy analysis of adenomammectonny with preservation of nipple-areola sensation in treatment of gynecomastia

作　　者：张彦武[1] 吕以东[1] 牛耀东[1] 严文君[1] 冯爱强[1] 

机构地区：[1]郑州大学第三附属医院乳腺科,河南郑州450052

出　　处：《中国普通外科杂志》2016年第11期1622-1626,共5页China Journal of General Surgery

摘　　要：目的：探讨保留乳头乳晕感觉的乳腺切除术治疗男性乳腺发育的疗效。方法：将58例男性乳腺发育患者随机分为观察组（28例）和对照组（30例），观察组采用吸脂＋保留外侧薄层腺体瓣的腺体次全切除术，对照组患者采用吸脂＋腺体切除术，仅保留乳头乳晕后方的少量腺体，所有患者术后均随访6个月，观察比较两组患者的手术效果和并发症情况。结果：观察组和对照组患者手术均顺利完成。观察组的术后24 h乳头乳晕感觉（χ2=9.946，P=0.007）和血运（χ2=4.913，P=0.026）均明显优于对照组；术后观察组较对照组胸壁不平坦的发生率明显降低（χ2=4.392，P=0.036）；术后血肿和血清肿的发生率两组间差异无统计学意义（均P〉0.05）；观察组的术后6个月乳头乳晕感觉优于对照组（χ2=6.054，P=0.014）。随访期间，两组均无复发。结论：与常规的吸脂＋腺体切除术比较，吸脂＋保留外侧薄层腺体瓣的腺体次全切除术疗效可靠、外观有优势、并发症无增加，尤其保护了乳头乳晕的感觉和血运，推荐临床采用。Objective： To investigate the efficacy and complications of adenomammectomy with preservation of nipple and areolar sensation in treatment of gynecomastia.Methods： Fifty-eight patients with gynecomastia were randomly designated to observation group （28 cases） and control group （30 cases）. Patients in observation group received liposuction and subtotal adenomammectomy with preservation of the superior lateral glandular flap, while those in control group underwent liposuction and adenomammectomy with only preservation of a small volume of glands behind the nipple-areola. All patients were followed up for 6 months after operation. The surgical efficacy and postoperative complications in the two groups of patients were observed and compared.Results： Operation was successfully completed in both groups of patients. The nipple-areola sensation and blood supply were significantly better in observation group than those in control group at 24 h after operation （χ2=9.946, P=0.007; χ2=4.913, P=0.026）; the incidence of postoperative chest wall unevenness in observation group was significantly reduced compared with control group （χ2=4.392, P=0.036）; no significant difference was found in incidence of either postoperative hematoma or seroma between the two groups （both P〉0.05）; the nipple-areola sensation was significantly better in observation group than that in control group at 6 months after operation （χ2=6.054, P=0.014）. No recurrence was noted in either group during follow-up period.Conclusion： Compared with conventional liposuction and adenomammectomy, liposuction plus subtotal adenomammectomy with preservation of the superior lateral glandular flap offers advantage in postoperative appearance without increasing complications and especially, it can preserve the nipple-areola sensation and blood supply. So, it is recommended to be used in clinical practice.

关 键 词：乳腺发育 男性 乳房切除术/方法 手术后并发症 

分 类 号：R655.8[医药卫生—外科学]