背阔肌肌皮瓣与腹直肌皮瓣移植修复乳腺癌根治术后创面的效果观察  

ffflflThe effect of latissimus dorsi flap and rectus abdominis flap transplantation in the repair of wounds after radical mastectomy

作　　者：纪登峰 张鹏 赵玉亭 JI Deng-feng;ZHANG Peng;ZHAO Yu-ting(Xinmi City Hospital of Traditional Chinese Medicine general surgery,Henan Province 452370,China;Henan Armed Police Corps Hospital,Henan Province,450052,China)

机构地区：[1]新密市中医院普外科,河南新密452370 [2]河南省武警总队医院,河南郑州450052

出　　处：《中国医疗美容》2024年第2期40-46,共7页China Medical Cosmetology

摘　　要：目的探究背阔肌肌皮瓣与腹直肌皮瓣在乳腺癌根治术创面修复中的应用价值。方法收集2020年4月至2022年12月我院200例行乳腺癌根治术患者临床资料,根据术中移植皮瓣不同分为背阔肌组100例(背阔肌肌皮瓣修复)和腹直肌组100例(腹直肌皮瓣修复)。比较两组围手术期指标、组织血氧参数[末梢血流灌注量、氧分压(TePO_(2))]、并发症、乳房美观效果(Harris评分)及生活质量满意度。结果背阔肌组手术时间(6.72±0.28)h、血管蒂长度(6.62±0.29)cm、住院时间(17.43±2.81)d短于腹直肌组[(7.12±0.37)h、(10.58±0.54)cm、(20.22±3.01)d],皮瓣温度(35.31±0.39)℃、皮瓣一期成活率95.00%高于腹直肌组[(34.92±0.41)℃、86.00%](P<0.05);术后1周,背阔肌组末梢血流灌注量为(139.72±16.29)BPU,高于腹直肌组的(131.28±17.53)BPU,TePO2为(64.71±8.47)mmHg,高于腹直肌组的(60.94±8.25)mmH(P<0.05);背阔肌组并发症发生率4.00%与腹直肌组8.00%比较,无显著差异(P>0.05);术后6个月两组乳房美学效果、生活质量满意度比较,均无显著差异(P>0.05)。结论背阔肌肌皮瓣、腹直肌皮瓣是乳腺癌根治术后安全可靠的乳房重建方式,而前者能优化手术流程,改善早期皮瓣微循环,有助于皮瓣成活,加快术后恢复进程。Objective To explore the application value of latissimus dorsi flflap and rectus abdominis flflap in wound repair after radical mastectomy.Methods The clinical data of 200 patients who underwent radical mastectomy in our hospital from April 2020 to December 2022 were collected,and they were divided into 100 cases in the latissimus dorsi group(latissimus dorsi flflap repair)and 100 cases in the rectus abdominis group(rectus abdominis flflap repair)according to the intraoperative transplantation flflap.Perioperative indexes,tissue blood oxygen parameters[peripheral perfusion volume,partial pressure of oxygen(TePO_(2))],complications,breast aesthetic effect(Harris score)and quality of life satisfaction were compared between the two groups.Results The operation time of(6.72±0.28)h,the length of the vascular pedicle(6.62±0.29)cm,and the length of hospital stay in the latissimus dorsi group were(17.43±2.81)days shorter than those in the rectus abdominis group[(7.12±0.37)h,(10.58±0.54)cm,(20.22±3.01)d],the flflap temperature was(35.31±0.39)℃,and the survival rate of the fifirst flflap was 95.00%higher than that in the rectus abdominis group[(34.92±0.41)℃.86.00%](P<0.05);at 1 week postoperatively,the peripheral blood perfusion volume of the latissimus dorsi group was(139.72±16.29)BPU,which was higher than that of the rectus abdominis group(131.28±17.53)BPU,and the TePO2 was(64.71±8.47)mmHg,which was higher than that of the rectus abdominis group(60.94±8.25)mmH(P<0.05);the complication rate in the latissimus dorsi group was 4.00%,which was not signifificantly difffferent from the 8.00%in the rectus abdominis group(P>0.05),and there was no signifificant difffference in breast aesthetic effffect and quality of life satisfaction between the two groups at 6 months after surgery(P>0.05).Conclusion Latissimus dorsi flap and rectus abdominis flap are safe and reliable methods for breast reconstruction after radical mastectomy,and the former can optimize the surgical process,improve the microcirculation of the flf

关 键 词：乳腺癌 乳腺癌根治术 乳房重建 背阔肌肌皮瓣 腹直肌皮瓣 美观效果 组织血氧参数 

分 类 号：R737.9[医药卫生—肿瘤]