应用腹壁下动脉穿支游离皮瓣移植乳房再造  

Breast reconstruction by deep inferior epigastric perforator flap

作　　者：徐军[1] 靳小雷[2] 刘元波[2] 穆兰花[2] 朱晓峰[2] 杨红岩[1] 晏晓青[1] 于浩[2] 

机构地区：[1]中国医学科学院中国协和医科大学北京协和医院整形外科,北京100041 [2]中国医学科学院中国协和医科大学整形外科医院

出　　处：《中华医学美学美容杂志》2004年第2期65-68,共4页Chinese Journal of Medical Aesthetics and Cosmetology

基　　金：2 0 0 1年度人事部归国人员科研基金资助项目

摘　　要：目的　通过应用腹壁下动脉穿支游离皮瓣移植进行乳房再造的手术方法 ,总结应用该方法进行乳房再造的临床经验。方法　切取以腹壁下动静脉为蒂的穿支游离皮瓣 ,将腹壁下动静脉与胸廓内动静脉相吻合 ,进行乳房再造。结果　自 2 0 0 0年以来 ,临床应用腹壁下动脉穿支皮瓣再造乳房共 15例 ,10例皮瓣 10 0 %成活 ,2例皮瓣远端局部皮肤坏死 ,1例皮瓣远端脂肪硬结 ,2例皮瓣完全坏死。随访6个月至 1年 ,再造乳房外形满意 ,供区无腹壁疝、腹壁膨出、腹壁薄弱等并发症发生。结论　腹壁下动脉穿支游离皮瓣是下腹部横行腹直肌肌皮瓣 (TRAM皮瓣 )的技术改良与发展 ,该皮瓣具有血运丰富、组织量大、易于塑形、供区损伤小等优点 ,是一种安全可靠的乳房再造方法。Objective To present a method for breast reconstruction with the deep inferior epigastric perforator (DIEP) flap and to summarize the operative experiences. Methods DIEP flaps were elevated without carrying rectus abdominis muscle. The breast was shaped after the deep inferior epigastric artery and vein were anastomosed to the internal mammary artery and vein. Results Since 2000, we have used the DIEP flaps in 15 cases of breast reconstruction. There were 100 % survival in 10 flaps, distal skin necrosis in 2 flaps, and a full loss in 2 flaps. With the follow-up of 6～12 months, the reconstructed breasts were well-shaped and there were no complications such as abdominal heria, bulge and weakness in donor sites. Conclusion DIEP flap is the development and refinement of TRAM flap and possesses of advantages such as rich blood supply, abundant tissue volume, minimal donor site morbidity and easy shaping. It is a new but reliable and safe technique for autologous breast reconstruction.

关 键 词：腹壁下动脉穿支游离皮瓣移植 乳房再造 手术方法 乳房缺如 

分 类 号：R737.9[医药卫生—肿瘤]