两种皮瓣修复法对乳腺癌改良根治术后整形效果及血清炎症因子水平的影响  

Effects of Two Skin Flap Repair Methods on Plastic Effect and Serum Inflammatory Factor Levels after Modified Radical Mastectomy for Breast Cancer

作　　者：支珍 夏群[1] 李巍[1] 马静[1] 陈洁[1] ZHI Zhen;XIA Qun;LI Wei;MA Jing;CHEN Jie(Department of Oncology,Bengbu First People's Hospital,Bengbu 233000,Anhui,China)

机构地区：[1]蚌埠市第一人民医院肿瘤科,安徽蚌埠233000

出　　处：《中国美容医学》2023年第5期67-70,共4页Chinese Journal of Aesthetic Medicine

摘　　要：目的:探讨两种不同皮瓣修复法对乳腺癌改良根治术后整形效果及血清炎症因子水平的影响。方法:选择2011年2月-2020年11月笔者医院行乳腺癌改良根治术并即刻乳房再造修复的86例患者为研究对象,按1∶1比例随机划分成两组。其中将接受横行腹直肌皮瓣(Transverse rectus abdominis myocutaneous flap,TRAM)再造修复的43例患者设为TRAM组,将接受背阔肌肌皮瓣(Latissimus dorsi myocutaneous flap,LDM)再造修复的43例患者设为LDM组。术后3个月,评价乳房整形效果,记录两组手术相关指标,检测两组术前、术后3 d白细胞(White blood cell,WBC)、C-反应蛋白(C-reactive protein,CRP)等炎症指标,观察两组术后3个月内并发症发生率。结果:术后3个月,TRAM组整形效果优良率(95.35%)高于LDM组(90.70%),但组间比较差异无统计学意义(P>0.05);两组术中失血量、手术时间、住院时间比较差异均无统计学意义(P>0.05);术后3 d,两组血清CRP水平及WBC计数和术前相比均明显增高(P<0.05),但LDM组上述指标均低于TRAM组(P<0.05);术后LDM组并发症发生率(6.98%)低于TRAM组(11.63%),但组间比较差异无统计学意义(P>0.05)。结论:乳腺癌改良根治术后行TRAM再造修复和LDM再造修复的整形效果均较佳,但后者与前者相比术后早期血清炎症因子水平更低。Objective To invetigate the effects of different skin flap repair methods on the cosmetic effect and serum infamatoary factor levels after mdified radical mastectomy for breast cancer.Methods From Febnuary 2019 to November 2020.86 patients who came to author's hospital hospital for modifed radical mastectomy and imediate breast reconstruction were selected as the research objects,and they were randomly divided into two goups at a ratio of 1:1.Among them,43 cases with transverse rectus abdominis myocutaneous flap(TRAM)were set as group A and 43 cases with latissimus dorsi myocutaneous flap(LDM)were set as group B.Three months after breast reconstruction,the cosmetic effect was evauatedsurgery-related indicators of the two groups were recorded.the white blood cell(WBC),C-reactive protein(CRP)and other inflammatory indexes were detected before and after surgery,and the complication rate of the two groups within three months after surgery was observed Results Three months after surgery,the excellent and good rate of plastic effect in group A was 95.35%,which was slightly higher than 90.70%in group B,but there was no significant difference between the two groups(P>0.05);there was no sgificant diference in blood loss operation time and hospital stay between the two groups(P>0.05);the senm CRP levels and WBC counts of the two groups were significanty higher than those before the operation 3 days after operation(P<0.05).but the above indexes of group B were significantly lower than those of group A(P<0.05);the incidence of postoperative complications in group B was 6.98%,slightly lower than 11.63%in group A.but there was no significant dfference between the two goups(P>0.05).Conclusion The cosmetic efect of TRAM reconstuction and LDM reconstruction after modifed radical mastectomy is better,but the ltter is lower than that of the fomer.

关 键 词：横行腹直肌皮瓣 背阔肌肌皮瓣 乳腺癌改良根治术 即时乳房再造 整形效果 免疫功能 

分 类 号：R622[医药卫生—整形外科]