乳腺癌保乳术中利用邻近侧胸壁筋膜皮瓣转移修复乳房缺损的临床效果研究  

A Study on the Clinical Effectiveness of Using the Adjacent Side of the Chest Wall Fascial Flap Transfer to Repair Breast Defects During Breast Cancer Breast Conserving Surgery

作　　者：许志强 吴秀萍 谢旺美 杨清默 XU Zhiqiang;WU Xiuping;XIE Wangmei;YANG Qingmo(Department of Breast Surgery,Zhangzhou Zhengxing Hospital,Zhangzhou,Fujian Province,363000 China)

机构地区：[1]福建省漳州正兴医院乳腺外科,福建漳州363000

出　　处：《中外医疗》2022年第36期77-80,89,共5页China & Foreign Medical Treatment

基　　金：北京医学会项目基金(YXJL-2020-0941-0746)。

摘　　要：目的 探讨乳腺癌(breast cancer,BC)保乳术中利用侧胸壁筋膜皮瓣修复乳房缺损的临床效果。方法随机选取2019年1月—2021年12月期间漳州正兴医院乳腺外科收治的120例BC患者作为研究对象,以随机数表法将其分为对照组(60例)与研究组(60例)。对照组行保留乳头乳晕改良根治术联合Ⅰ期扩张器乳房再造术,研究组行侧胸壁筋膜皮瓣转移修复乳房缺损。针对两组术中与术后情况、并发症、局部复发率、生活质量与乳房美容效果进行对比。结果 研究组手术耗时、术中失血量与住院时间均低于对照组,差异有统计学意义(P<0.05)。研究组术后并发症发生率(5.00%)较对照组(18.33%)低,差异有统计学意义(χ^(2)=5.175,P<0.05);两组局部复发率比较,差异无统计学意义(P>0.05)。术前两组健康调查简表(SF-36)评分比较,差异无统计学意义(P>0.05);术后6个月时,研究组SF-36评分结果高于对照组,差异有统计学意义(P<0.05)。研究组术后乳房美容的优良率(90.00%)高于对照组(75.00%),差异有统计学意义(χ^(2)=4.675,P<0.05)。结论 较于保留乳头乳晕改良根治术联合Ⅰ期扩张器乳房再造术,保乳腺BC患者应用侧胸壁筋膜皮瓣转移修复乳房缺损的美学效果更为理想,且可以降低并发症发生风险,缩短康复进程,保障患者的生活质量。Objective To investigate the clinical effect of using lateral chest wall fascial flap to repair breast defects during breast cancer(BC)breast conserving surgery.Methods One hundred and twenty BC patients admitted to the Department of Breast Surgery,Zhangzhou Zhengxing Hospital between January 2019 and December 2021 were randomnly selected as study subjects and divided into a control group(sixty cases)and a study group(sixty cases)by a random number table.The control group was treated with modified radical nipple-areola preservation combined with stageⅠexpander breast reconstruction,and the study group was treated with lateral chest wall fascial flap transfer to repair the breast defect.The intraoperative and postoperative conditions,complications,local recurrence rate,quality of life and cosmetic breast outcomes were compared between the two groups.Results The operative time,intraoperative blood loss and hospital stay in the study group were lower than those in the control group,the difference was statistically significant(P<0.05).The postoperative complication outcome in the study group(5.00%)was lower than that in the control group(18.33%),the difference was statistically significant(χ^(2)=5.175,P<0.05).There was no statistically significant difference in the local recurrence rate between the two groups,the difference was not statistically significant(P>0.05).There was no difference in The Mos Item Short From Health Survey(SF-36)scores between the two groups,(P>0.05).The SF-36 score in the study group was higher than that in the control group at 6 months postoperatively,the difference was statistically significant(P<0.05).The excellent rate of postoperative breast aesthetics in the study group was 90.00%higher than 75.00%in the control group,the difference was statistically significant(χ^(2)=4.675,P<0.05).Conclusion Compared with nipple areola preservation modified radical surgery combined with stage I expander breast reconstruction,the aesthetic results of applying lateral chest wall fascial flap transfer

关 键 词：乳腺癌 保乳术 保留乳头乳晕 胸壁筋膜皮瓣 乳房缺损 

分 类 号：R5[医药卫生—内科学]