股深动脉穿支皮瓣在乳房重建的应用  

Application of profunda artery perforator flap in breast reconstruction

作　　者：宋达疆[1] 李赞[1] 周晓[1] 章一新[2] 彭小伟[1] 周波[1] 吕春柳[1] 彭文[1] 欧延[1] 毛煌兴 

机构地区：[1]湖南省肿瘤医院肿瘤整形外科,长沙410008 [2]上海交通大学医学院附属第九人民医院整形外科

出　　处：《中华整形外科杂志》2017年第6期412-416,共5页Chinese Journal of Plastic Surgery

基　　金：湖南省自然科学基金面上项目（13JJ5012）;湖南省科技计划项目（2014SK3002）;湖南省卫计委课题项目（B2014-111）

摘　　要：目的探讨游离股深动脉穿支（profunda artery perforator, PAP）皮瓣在早期乳腺癌患者术后乳房再造中的临床应用。方法对6例早期乳腺癌患者行根治术或改良根治术同期或二期应用PAP皮瓣行乳房再造，其中乳腺癌分期Ⅰ期4例，Ⅱ期2例。患者年龄31-53岁，平均（36.2±5.9）岁。结果皮瓣长（25.2±0.2） cm、宽（6.4±0.8） cm、厚（2.6±0.2） cm，血管蒂长度为（7.2±0.6） cm，血管管径为（1.6±0.3） mm。皮瓣平均重量为345 g（225-575 g）。1例皮瓣出现脂肪液化，经换药后愈合，其余皮瓣均成活，再造乳房外形可，弹性好，无皮瓣挛缩变形；皮瓣供区仅遗留线性瘢痕，无下肢功能影响。6例获随访2-3个月，平均2.5个月，效果均较满意，未出现乳腺癌复发病例。结论PAP皮瓣是乳腺癌术后乳房再造的理想方法之一。Objective To explore the clinical application of the profunda artery perforator flap in breast reconstruction of patients with early-staged breast cancer. Methods Six cases of early breast cancer patients received radical or modified radieaI surgery. The PAP flap was used to reconstruct breast at the same time or in the second phase. Four cases of breast cancer were in stage I and 2 cases was in stage II. Results The length of flap was （25.2 ± 0.2） cm, the width of flap was （6.4 ± 0.8） cm, the thickness of flap was （2.6 ± 0.2） cm. The length of pedicle was （7.2 ± 0.6） cm, the outer diameter of pedicle was （ 1.6 ± 0.3 ） mm. The average weight of flap was 345 g（ ranged from 225 g to 575 g）. All profunda artery perforator flaps were successful. In one flap fat necrosis occurred and healed with dressing treatment. The reconstructed breasts＇ shape, texture and elasticity was good and no flap contracture deformation happened. Only linear scar left in the donor sites, the function of thighs was not affected. All 6 patients were followed up for 2 - 3 months （2.5 months on average） with satisfied result. No local recurrence happened. Conclusions PAP flap is suitable to reconstruct breast for breast cancer patients.

关 键 词：乳腺癌 股深动脉穿支皮瓣 乳房重建 

分 类 号：R622[医药卫生—整形外科] R737.9[医药卫生—外科学]