三维扫描成像在单侧假体乳房重建术前评估中的应用  

Application of 3D Scanning Imaging in Preoperative Evaluation of Unilateral Breast Reconstruction with Prosthesis

作　　者：林涛 王喜梅[1] 李志斌 谢百慧 闫成祥 LIN Tao;WANG Ximei;LI Zhibin;XIE Baihui;YAN Chengxiang(Department of Medical Plastic and Cosmetic Center,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,Henan,China)

机构地区：[1]郑州大学第一附属医院医学美容中心,河南郑州450052

出　　处：《中国美容医学》2024年第2期34-37,共4页Chinese Journal of Aesthetic Medicine

摘　　要：目的:探讨三维扫描成像在单侧假体乳房重建术前评估中的应用价值。方法:回顾性分析2018年1月-2021年9月于笔者科室行假体乳房重建术的15例单侧乳房萎缩或缺陷患者临床资料,所有患者术前均行三维扫描成像,得到术前乳房容量差异评估(Preoperative assessment of breast volume difference,PABVD),依据该结果得出最接近的乳房假体容量,记为预计假体容量(Predicted prosthesis volume,PPV);术中剥离腔隙后,将圆形扩张器置入腔隙,注水评估容量差异,即为术中乳房容量差异评估(Intraoperative assessment of breast volume difference,IABVD),以IABVD参考选择最为相近的假体容量,记为实际假体容量(Actual prosthesis volume,APV),置入假体后,重建乳房下皱襞。术后给予止痛泵镇痛、抗瘢痕综合治疗。统计学分析数据,并对患者术后并发症、医患沟通满意度及手术效果满意度进行随访。结果:PABVD为(181.6±39.0)ml,IABVD为(178.6±36.4)ml,两者比较差异无统计学意义(P>0.05),PPV与APV吻合率达93.33%(14/15),PABVD与APV有较强关联性(P<0.05)。术后随访3~6个月,再造乳房形态自然、挺拔,双侧较对称,切口瘢痕位于新的乳房下皱襞处,术后均无明显瘢痕增生、包膜挛缩、感染等并发症,医患沟通良好,患者对手术效果满意。结论:三维扫描成像能够精确获取乳房的外在轮廓,并在术前对乳房容量差异进行可靠评估,有利于医患之间良好沟通,同时对于手术规划及预选假体有重要参考价值。Objective To evaluate the application of 3D scanning and imaging in preoperative assessment of unilateral breast reconstruction with prosthesis.Methods A retrospective analysis was performed on 15 patients with unilateral breast atrophy or defect who underwent breast reconstruction with prosthesis in the author's department from January 2018 to September 2021.All 15 patients underwent 3D scanning and imaging before surgery,obtaining preoperative assessment of breast volume difference(PABVD).Predicted prosthesis volume(PPV)is the prosthesis volume closest to the above result.During the operation,after precisely dissecting the lacunae,the volume of water injected into the circular expander was recorded as intraoperative assessment of breast volume difference(IABVD),and actual prosthesis volume(APV)was determined based on it.Then the selected prosthesis was implanted and the inframammary fold was reconstructed.After operation,patients were given analgesic pump and combined anti-cicatricial treatment.Postoperative complications,breast morphology,and whether the patient is satisfied with doctor-patient communication and the surgical results were followed up.Results PABVD was(181.6±39.0)ml,IABVD was(178.6±36.4)ml,there was no significant difference between the two groups(P>0.05).The coincidence rate of PPV and APV was 93.33%(14/15),PABVD and APV had a strong correlation(P<0.05).Postoperative following up lasted from 3 months to 6 months.No complications such as hematoma,capsular contracture or infection occurred.The breast shape was natural and symmetrical bilaterally.The patients were very satisfied with doctor-patient communication and the operation effect.Conclusion 3D scanning imaging can accurately obtain the external contour of the breast,and reliably evaluate the breast volume difference before surgery,which is conducive to good communication between doctors and patients,and highly beneficial for surgical planning and preselection of the prosthesis.

关 键 词：三维扫描 乳房重建 乳房容量 三维成像 硅胶假体 

分 类 号：R622[医药卫生—整形外科]