脂肪抽吸联合组织旋切治疗男性乳房发育症的临床研究  

Surgical treatment of gynecomastia by liposuction and vacuum-assisted biopsy device

作　　者：徐华[1] 张亦[1] 王庭亮[1] 刘莺[1] 董佳生[1] 梁宝宝 Xu Hua;Zhang Yi;Wang Tingliang;Liu Ying;Dong Jiasheng;Liang Baobao(Department of Plastic and Reconstructive Surgery,Shanghai Ninth People’s Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200011,China;Department of Oncology,the Second Affiliated Hospital,Xi′an Jiaotong University,Xi′an 710004,China)

机构地区：[1]上海交通大学医学院附属第九人民医院整复外科,200011 [2]西安交通大学第二附属医院肿瘤科,710004

出　　处：《中华整形外科杂志》2021年第10期1096-1101,共6页Chinese Journal of Plastic Surgery

摘　　要：目的探讨采用脂肪抽吸联合组织旋切治疗SimonⅠ度或Ⅱ度脂肪腺体混合型男性乳房发育症(GYN)的临床效果。方法回顾性分析2016年6月至2019年6月,同一术者于上海交通大学医学院附属第九人民医院整复外科采用脂肪抽吸联合组织旋切法治疗的SimonⅠ度或Ⅱ度脂肪腺体混合型GYN的病例资料。手术方法于手术范围下界与腋前线交界处设计5 mm长的切口,通过该切口首先对GYN患者胸部增生的脂肪组织进行抽吸,然后应用乳房活检与旋切系统切除残余的腺体结缔组织。记录手术时间、脂肪抽吸量、组织旋切量、旋切时出血量、总引流量、引流管留置时间及并发症。于2020年6至12月对患者进行随访,并让患者对胸部美观程度满意度进行评分,分值范围0~5分,0分为极度不满意,5分为极度满意。应用SPSS 19.0整理和分析数据,数据以均值±标准差或M(P25,P75)表示。结果共27例GYN 51侧乳房纳入该研究,单侧手术时间为(45.3±11.1)min,脂肪抽吸量为(206.0±66.7)ml,组织旋切量为(28.9±9.5)g,旋切时出血量为(10.0±4.3)ml,总引流量为(78.8±33.9)ml,引流管留置时间为(2.3±0.4)d。术后共有9侧胸部皮肤有淤斑形成,无其他并发症发生。术后随访时间为21.0(17.0,28.0)个月,患者满意度评分为(4.98±0.14)分。结论脂肪抽吸联合组织旋切治疗SimonⅠ度或Ⅱ度脂肪腺体混合型GYN并发症少,安全可靠,术后胸壁外形美观,患者满意度高,但存在术中无法确切止血等不足。Objective This study intends to explore the clinical outcomes of liposuction combined with a vacuum-assisted biopsy device in the treatment of Simon gradeⅠorⅡgynecomastia(GYN)caused by glandular proliferation and excrescent fat deposition.Methods The clinical data of Simon gradeⅠorⅡGYN caused by glandular proliferation and excrescent fat deposition treated by liposuction and vacuum-assisted biopsy device in the Department of Plastic and Reconstructive Surgery of the Ninth People’s Hospital Affiliated to Medical College of Shanghai Jiao Tong University from June 2016 to June 2019 were analyzed retrospectively.Surgical procedures:A 5-mm skin incision was made at the lower outer margin of the breast,through which the excrescent fat deposition was removed by liposuction.In addition,a vacuum-assisted biopsy device was applied to remove the residual glandular tissue.The operation time,liposuction volume,removed glandular tissue weight,blood loss,drainage volume,drainage duration,patient satisfaction,and complications were observed and recorded.The patients were followed up from June to December 2020.Patients were asked to grade the cosmetic outcome between 0 and 5(0 was extremely dissatisfied,5 was extremely satisfied).The data were sorted out and analyzed by SPSS 19.0,and the data were expressed as Mean±SD or M(P25,P75).Results A total of 27 patients with 51 breasts were enrolled in this study.Unilateral operation time,liposuction volume,removed glandular tissue weight,blood loss,drainage volume,drainage duration were(45.3±11.1)min,(206.0±66.7)ml,(28.9±9.5)g,(10.0±4.3)ml,(78.8±33.9)ml and(2.3±0.4)d respectively.Bruising occurred in 9 breasts.No other complications were observed.The postoperative follow-up time was 21.0(17.0,28.0)months,and the score of patient satisfaction was 4.98±0.14.Conclusions Liposuction combined with vacuum-assisted biopsy device can be used as a feasible and minimally invasive approach to treat the Simon gradeⅠorⅡGYN caused by glandular proliferation and excrescent fat de

关 键 词：男性乳房发育 脂肪抽吸 真空辅助乳房活检装置 微创外科手术 

分 类 号：R655.8[医药卫生—外科学]