乳房缩小术对乳房及乳头乳晕复合体感觉影响的研究进展  

Research progress on the effect of breast reduction surgery on breast and nipple-areola complex sensation

作　　者：李婉迪 申传安 Li Wandi;Shen Chuan’an(Senior Department of Burns and Plastic Surgery,the Fourth Medical Center of PLA General Hospital,Beijing 100048,China)

机构地区：[1]中国人民解放军总医院第四医学中心烧伤整形医学部,北京100048

出　　处：《中华整形外科杂志》2023年第11期1262-1266,共5页Chinese Journal of Plastic Surgery

基　　金：国家自然科学基金面上项目(82072169,82272279)。

摘　　要：乳房肥大症患者常因乳房体积过大,造成胸部皮肤麻木、肩背疼痛、皮肤湿疹、运动不便等问题,严重影响生活质量。随着患者对生活质量要求的提高,乳房和乳头乳晕复合体(NAC)感觉的重要性逐渐得到研究者的关注。该文通过回顾采用定量感觉测试评估乳房及NAC感觉变化的相关研究,介绍了Semmes-Weinstein单丝检查(SWME)和指定压力感觉测试仪(PSSD),以及乳房肥大症患者乳房及NAC的感觉变化,同时总结了造成乳房缩小整形术后皮肤感觉变化的主要因素。研究发现在乳房肥大症患者的感觉异常中,乳头和乳晕的感觉变化并不一定完全一致。蒂的位置选择可能影响术后乳房及NAC的感觉,其中上蒂和外上蒂损伤NAC支配神经风险增加,可能造成术后部分区域的皮肤敏感度在一定时间内显著下降。另外,乳房体积较大的患者手术获益可能更大。同时,乳腺组织切除量与感觉变化无显著相关性。Patients with breast hypertrophy often have breast and nipple-areolar complex(NAC)skin paresthesia,shoulder or back pain,eczema,reduced mobility,and other problems,which seriously decline the quality of life.With the improvement of patients’requirements for life quality,researchers have gradually paid attention to the importance of breast and NAC sensation.This paper introduced Semmes-Weinstein monofilaments examination(SWME),pressure-specified sensory device(PSSD),and the hypotheses of breast and NAC sensory change in patients with mammary hypertrophy.The main factors causing sensory change after breast reduction surgery were also summarized.In these patients,the sensory change of the nipple and areola are not necessarily consistent.Pedicle selection could probably affect postoperative breast and NAC sensation.Notably,the superior pedicle and superolateral pedicle could bring some risks to the innervation of NAC,which might cause a significant decrease in postoperative skin sensitivity within a certain period.In addition,patients with larger breasts probably could benefit more from surgery,and the resection volume was not significantly associated with sensory change.

关 键 词：乳房 乳房成形术 感觉 

分 类 号：R655.8[医药卫生—外科学]