背阔肌肌皮瓣在乳腺切除术后乳房再造和创面修复中的临床应用

发布时间：2018-02-05 17:44

  本文关键词： 乳腺切除术 背阔肌皮瓣移植 I期乳房再造 创面修复 术后美容 术后并发症　出处：《广西医科大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:探讨背阔肌皮瓣在多种乳房切除术后乳房再造或晚期乳腺癌切除术后创面修复术方面的临床应用效果。方法:回顾性分析2012年12月至2016年12月间我院接受乳房切除术后背阔肌肌皮瓣移植术患者的临床病理资料,随访术后并发症,均术后3月随访美容效果。采用Harris美容评价标准,采用SPSS 21.0软件做统计分析。分析乳腺肿瘤部位,大小,淋巴结清扫术,切取皮瓣大小、乳腺手术方式对术后美容效果及术后并发症率的影响,并做Χ2检验分析。结果:总计42例手术,Ⅰ期乳房重建30例,单纯创面修复术12例,术后患者总体美容满意度较高,优秀率达80.56%,良好率达29.44%,无差评。数据分析美容效果与肿瘤位置、大小、是否做淋巴结清扫术、乳腺切除术的术式对术后美容效果评价均无显著差异性(P0.05)。无术后远期严重并发症,术后近期并发症有背部血清肿,9例(21.4%),切口愈合延迟例3例(7.5%)。这些与切取皮瓣大小有显著相关性(P0.05)。患侧上肢异常感觉与行腋窝淋巴结清扫术有显著相关性(P0.05)。结论带蒂背阔肌皮瓣移植术既能为乳腺癌保乳整形术,保守性乳腺切除术后乳腺重建提供自体组织来源,也能为改良根治术或根治术后胸壁创面修复提供技术支持和保障,在乳腺癌手术治疗方面的临床适应性广。应用于保乳或重建乳房的美容效果好,术后远期满意度高。对乳腺肿瘤灶大,切除后胸壁缺损大,切口缝合困难的患者能提供及时创面修复,且手术成功率高,严重术后并发症率不高,能为各种乳房切除术的成功提供技术保障,临床实用价值高。
[Abstract]:Objective: to investigate the clinical application of latissimus dorsi flap in reconstruction of breast after multiple mastectomy or wound repair after resection of advanced breast cancer. The clinicopathological data of patients with latissimus dorsi myocutaneous flap after mastectomy from December 2012 to December 2016 were retrospectively analyzed. The postoperative complications were followed up on March. Harris beauty evaluation standard and SPSS 21.0 software were used to analyze the location and size of breast tumor. The effect of lymph node dissection, flap size and mammary gland operation on postoperative cosmetic effect and postoperative complication rate were analyzed. Results: 42 cases were operated on, 30 cases were stage 鈪，

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