微创切口不同术式治疗男性乳腺发育症的效果分析  

Analysis of the efficacy of different minimally invasive incisions in the treatment of gynecomastia

作　　者：杨阳 张茂红 孙丰华 孙诚 胡云健 YANG Yang;ZHANG Mao-hong;SUN Feng-hua;SUN Cheng;HU Yun-jian(Department of Burn and Plastic Surgery, General Hospital of Eastern Theater Command, Nanjing 210002, China)

机构地区：[1]东部战区总医院(原解放军第八一医院)烧伤整形科

出　　处：《中国美容整形外科杂志》2019年第10期608-610,618,共4页Chinese Journal of Aesthetic and Plastic Surgery

摘　　要：目的寻求一种疗效佳且美观的治疗男性乳腺发育症(gynecomastia, GYN)的手术方式。方法自2015年6月至2018年12月,将收治的60例GYN患者分成单纯脂肪抽吸术(A组12例);脂肪抽吸联合乳晕小切口乳腺切除术(B组22例);乳晕缘切口乳腺切除术(C组26例)。比较3组在切口长度、手术时间、术后满意率和感觉方面的差异。结果 A组切口长度明显小于B、C组,其差异具有统计学意义(P<0.05),B组和C组无明显差异;A组手术时间与B组无明显差异,但均明显长于C组,其差异具有统计学意义(P<0.05);B组术后满意率与C组无明显差异,但明显好于A组,其差异具有统计学意义(P<0.05);术后A、B、C组的乳头乳晕感觉异常率分别为8.3%、13.6%和11.5%。结论单纯脂肪抽吸术切口较小,瘢痕不明显,但手术时间相对较长,术后易复发,适合脂肪型GYN患者;乳晕缘切口乳腺切除术具有切口较隐蔽、疗效较彻底、手术时间较短等优点,适合各种分型的GYN患者,但有时结合脂肪抽吸术可达到更好的疗效。Objective To seek an aesthetic and effective surgical procedure in the treatment of gynecomastia(GYN). Methods From June 2015 to December 2018, 60 patients with GYN were divided into 3 groups: the 12 patients in group A underwent simple suction lipectomy, the 22 patients in group B underwent suction lipectomy combined with adenomammectomy through a small incision along the inferior margin of the areolar, the 26 patients in group C underwent adenomammectomy through a periareolar incision. The difference in the length of the incision, operative duration, postoperative satisfaction rate and the sensation in the nipple and areola between the 3 groups were observed and compared. Results Group A had significantly smaller incisions compared with group B and C(P<0.05),while no significant difference was detected between the latter two groups. Operative duration was shorter in group C than that in the other two groups(P<0.05), while no obvious difference was found between group A and B. There was better postoperative satisfaction in patients in group B and C than that in group A(P<0.05), while no significant difference was found between the latter two groups. The postoperative incidence rate of abnormal sensation of the nipple and areola of group A, B, and C was 8.3%, 13.6% and 11.5%, respectively.Conclusion Simple suction lipectomy was better for patients with fatty GYN, resulting in smaller incisions and invisible scars. However,the disadvantage was longer operative duration and higher recurrence rate. Adenomammectomy through periareolar incision was feasible for GYN of all types with the advantages of an invisible incision, thorough curative effect, and a short operative duration. However, it is worth noting that in some cases, better curative effect can be gained when this procedure is combined with suction lipectomy.

关 键 词：男性乳腺发育症 脂肪抽吸术 乳晕缘切口 疗效比较 

分 类 号：R655.8[医药卫生—外科学]