游离下腹壁皮瓣应用于乳腺癌一期乳房重建33例临床分析  

Clinical analysis of first stage breast reconstruction for breast cancer with free lower abdominal wall flap in 33 cases

作　　者：李惠 杨庄青[1] 郭瑢 王常安 周绍强[1] 王建逵[1] 陈德滇[1] 黄胜 LI Hui;YANG Zhuangqing;GUO Rong;WANG Chang'an;ZHOU Shaoqiang;WANG Jiankui;CHEN Dedian;HUANG Sheng(Department of Breast SurgeryⅡ,Yunnan Cancer Hospital,Yunnan,Kunming 650118,China)

机构地区：[1]云南省肿瘤医院乳腺外二科,云南昆明650118 [2]昆明医科大学

出　　处：《中国医药科学》2021年第20期32-35,共4页China Medicine And Pharmacy

基　　金：国家自然科学基金(81860465)。

摘　　要：目的乳腺癌患者术后接受乳房重建的比例正逐年增高,本研究旨在探讨游离下腹壁皮瓣乳房重建术应用于乳腺癌一期乳房重建的效果与安全性。方法对2019年5月至2021年3月云南省肿瘤医院乳腺外二科33例确诊乳腺癌需行乳房切除的患者行一期游离下腹壁皮瓣乳房重建术。使用Breast-Q量表对患者进行自我满意度评价,并记录来自外科医生的Harris美学评价。结果32例患者皮瓣成活,其中5例出现乳房囊袋部分表皮缺血结痂愈合;另1例患者因“皮瓣静脉血栓形成”切除皮瓣。术后腹壁功能良好,仅1例患者因腹部瘢痕增生致腹部运动轻微受限。32例皮瓣成活患者Breast-Q术后评分:乳房满意度评分(68.51±3.50)分,手术满意度评分(76.54±6.50)分,胸部健康评分(69.53±3.50)分,腹部健康评分(73.52±3.50)分。外科医生Harris美学评价:优秀21例,良好9例,尚可2例,未见外形差的病例。结论游离下腹壁皮瓣乳房重建术使乳房缺失的患者得到较佳的乳房外观,美容效果较好,且并发症较少、手术安全性较高。Objective The proportion of breast cancer patients receiving breast reconstruction after surgery is increasing year by year.This study intends to explore the effect and safety of first stage breast reconstruction for breast cancer with free lower abdominal wall flap.Methods The first stage breast reconstruction with free lower abdominal wall flap was performed on 33 patients diagnosed with breast cancer who required mastectomy in the Department of Breast SurgeryⅡof Yunnan Cancer Hospital from May 2019 to March 2021.Self-satisfaction in patients was evaluated by using the Breast-Q scale,and Harris aesthetic evaluations from the surgeons were recorded.Results The flap survived in 32 patients,including 5 with epidermal ischemic healing at the breast pouch,and the remaining 1 patient was removed for flap due to"vein thrombosis at the flap".The postoperative abdominal wall function was good,and only one patient had slight restriction of abdominal movement due to abdominal scar hyperplasia.32 patients with survived flaps had postoperative Breast-Q scores of satisfaction with breast score(68.51±3.50),the surgical satisfaction score(76.54±6.50),the chest health score(69.53±3.50),and the abdominal health score(73.52±3.50).Harris aesthetic evaluations from the surgeons including excellent in 21 cases,good in 9 cases,fair in 2 cases,and no cases with poor appearance.Conclusion Breast reconstruction with free lower abdominal wall flap allows patients with breast loss to obtain better breast appearance and sound cosmetic effect,with few complications and high surgical safety.

关 键 词：乳腺癌 乳房重建 游离下腹壁皮瓣 美容效果 

分 类 号：R737.9[医药卫生—肿瘤]