标准化方案在乳腺癌术后游离大网膜即刻乳房重建术中的应用  

Standardized approach for immediate breast reconstruction with free omentum transplantation after breast cancer surgery

作　　者：石雪芹 郑朝 胡大海 韩军涛 何亭 刘苗苗 王志娟 周琴 SHI Xueqin;ZHENG Zhao;HU Dahai;HAN Juntao;HE Ting;LIU Miaomiao;WANG Zhijuan;ZHOU Qin(Department of Burns&Cutaneous Surgery,the Burn Center of the Whole Army,First Affiliated Hospital of Air Force Medical University,Xi′an 710032,China)

机构地区：[1]空军军医大学第一附属医院烧伤与皮肤外科全军烧伤中心

出　　处：《西北国防医学杂志》2019年第12期727-731,共5页Medical Journal of National Defending Forces in Northwest China

基　　金：国家自然科学基金项目(81601689);国家卫计委公益性行业科研专项项目(201502015);西京医院学科助推计划项目-先进学科建设项目(XJZTI8X05);空军军医大学第一附属医院2018年度学科助推计划-自由探索项目(XJZT18ML29)

摘　　要：目的:探讨在腔镜下游离大网膜为乳腺癌患者即刻重建乳房的方法,以最大限度满足患者需求。方法:本研究选取2016-07~2018-12我科乳腺癌术后行游离大网膜即刻乳房重建术患者20例进行研究分析,均为女性,年龄25~45(36.0±7.3)岁。结果:20例患者创面均一期愈合,术后伤口血运良好,无明显并发症,未行二次手术,达到预期美容效果。术后持续随访3~12个月,1例发现复发和转移。结论:游离大网膜重建术血运丰富,能与皮肤及胸大肌建立血运联合,从而减少皮瓣坏死的可能性,术后效果好,患者满意度较高,值得临床借鉴。Objective:To explore the immediate breast reconstruction method for breast cancer patients after radical operation through free great omentum transplantation under laparoscope.Methods:Twenty female patients aged 25-45(36.0±7.3)from July 2016 to December 2018 were included in the study,all of them underwent immediate breast reconstruction with free great omentum transplantation after breast cancer operation.Results:All of the 20 patients healed after surgery.The blood supply of transplanted tissue was satisfying.No obvious complications occurred.No second operation needed.The expected cosmetic effect was achieved,and the appearance of the breast was satisfying.During the 3 to 12 months followed-up,one patient suffered from tumor recurrence and metastasis,while others did not.Conclusion:Free great omentum has abundant blood supply,which can be combined with local skin and pectoralis major muscle to reduce the possibility of tissue necrosis.This method retains the shape of the breast through autologous tissue.The effect as well as the satisfaction rate of the patients is satisfying.It is worthy of clinical use.

关 键 词：乳腺癌 大网膜 乳房再造 护理 

分 类 号：R737.9[医药卫生—肿瘤]