改良持续外牵引悬吊术治疗先天性轻中度乳头内陷的临床研究

发布时间：2018-03-06 23:25

本文选题：乳头内陷　切入点：改良持续外牵引法　出处：《西南医科大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:研究一种治疗先天性轻中度乳头内陷的持续外牵引悬吊术式;探讨该法对先天性轻中度乳头内陷治疗的有效性和稳固性;探讨巩固期治疗是否可以有效的减少乳头回缩率。方法:选取四川省医学科学院四川省人民医院整形外科2015年1月至2016年8月32例18~30岁先天性轻中度乳头内陷女性未生育患者,随机分为甲、乙两组,甲组16例,乙组16例,甲组轻、中度内陷乳头数量(个)分别为16、15,乙组轻、中度内陷乳头数量(个)分别为16、16。甲乙两组均行改良持续外牵引悬吊术,其中甲组牵引期末治疗结束,乙组在牵引期末增加巩固期治疗,甲组在术前(T0)、牵引期末(T1)、牵引期结束后80天(T2)分别追踪测量乳头高度和体积,乙组在术前(T0)、牵引期末(T1)、巩固期末(T2)及治疗结束后半年(T3)分别追踪测量乳头高度和体积。从所有病例高度和体积在T1和T0的变化论证改良持续外牵引悬吊术对乳头内陷治疗的有效性及对轻、中度乳头内陷治疗的差异性;从甲、乙两组病例高度和体积在T2和T1的变化论证巩固期治疗是否可以有效的防止乳头回缩;从乙组病例高度和体积在T3和T2的变化论证改良持续外牵引悬吊术联合巩固期治疗对对乳头内陷治疗的稳固性和持久性。测量结果使用SPSS22.0进行统计学分析。结果:1、该研究中两组乳头内陷患者乳头高度和乳头体积在T1和T0的变化F值分别为1243.030、681.005,对应的p值为0.001、0.001,差异有统计学意义,说明改良持续外牵引悬吊术可以有效治疗轻、中度乳头内陷;2、轻度、中度乳头内陷患者乳头高度和体积在T1和T0的变化F值分别为0.044、0.005,对应的p值分别为0.835、0.942,p值0.05,差异无统计学意义,不认为改良持续外牵引法对先天性轻中度的治疗效果存在统计学差异,也说明改良持续外牵引悬吊术对轻度乳头内陷的效果不一定优于中度乳头内陷;3、甲、乙两组在牵引期末(T1)与牵引期结束后80天(T2)的乳头高度和体积变化F值分别为208.870、75.442,对应的p值分别为0.001、0.001,说明增加巩固期治疗可以有效减少先天性轻中度乳头内陷患者牵引悬吊后乳头回缩率;4、该研究乙组患者在治疗T3和T2的高度和体积变化F值分别为0.001、0.384,对应的p值分别为0.975、0.537,p值均0.05,差异无统计学意义,不能认为改良持续外牵引悬吊术术后T3和T2患者乳头的高度和体积存在差异,也说明该法对乳头内陷治疗的稳固性。结论:1、改良持续外牵引悬吊术对轻度、中度乳头内陷均有效;2、改良持续外牵引悬吊术对轻度乳头内陷及中度乳头内陷的治疗有效性差异不明显;3、巩固期的维持治疗可有效减轻先天性轻中度乳头内陷患者牵引悬吊术后乳头回缩程度,降低乳头回缩率,保证悬吊牵引手术效果;4、改良持续外牵引悬吊术用于对轻、中度乳头内陷的治疗,可有效的防止术后乳头回缩,保持乳头牵出稳固性。
[Abstract]:Objective: to study a method of continuous external traction suspension for congenital mild and moderate nipple invagination, and to explore the effectiveness and stability of this method in the treatment of congenital mild and moderate nipple invagination. To explore whether consolidation treatment can effectively reduce the rate of nipple retraction. Methods: from January 2015 to August 2016, 32 women (1830 years old) with congenital mild to moderate nipple collapse were selected from plastic surgery department of Sichuan Provincial people's Hospital, Sichuan Academy of Medical Sciences. They were randomly divided into two groups: group A (n = 16), group B (n = 16), group B (n = 16), group A (n = 16), group B (n = 16). In group A, the end of traction treatment was completed, and in group B, the consolidation phase was increased at the end of traction. In group A, the height and volume of nipples were measured before and 80 days after the end of traction. In group B, the height and volume of nipple were measured with T0, T1, T2) and T3 after treatment. The changes of the height and volume of all cases in T1 and T0 were used to demonstrate the effect of modified external traction suspension on the breast. The effectiveness of cephalic invagination treatment and its effect on mild, According to the changes of the height and volume of patients in T 2 and T 1 in group A and B, it was proved that consolidation therapy could effectively prevent the retraction of nipple. The stability and persistence of modified continuous external traction suspension combined with consolidation therapy in the treatment of nipple invagination were demonstrated in terms of the changes of height and volume at T3 and T2 in group B. the results were statistically analyzed by SPSS22.0. In this study, the changes of nipple height and nipple volume at T1 and T0 were 1243.030 and 681.005, respectively, and the corresponding p values were 0.001and 0.001, respectively. It shows that the modified continuous external traction suspension can effectively treat mild and moderate nipple invagination. The changes of the height and volume of the nipple at T1 and T0 in the patients with moderate nipple invagination were 0.044 卤0.005, respectively, and the corresponding p values were 0.835 and 0.942, respectively. There was no significant difference between the two groups. It is not considered that there is statistical difference in the therapeutic effect of modified continuous external traction for congenital mild and moderate congenital nipple cavities. It also shows that the effect of modified continuous external traction suspension on mild nipple invagination is not necessarily better than that of moderate nipple invagination. The change of nipple height and volume in group B were 208.870 nipple height and 75.442 at the end of traction period and 80 days after the end of traction period, and the corresponding p values were 0.001 / 0.001, respectively, indicating that increasing consolidation treatment can effectively reduce congenital mild and moderate nipple invagination. In group B, the height and volume of T _ 3 and T _ 2 were 0.001 and 0.384, respectively, and the corresponding p values were 0.9750.537p and 0.05. there was no significant difference between the two groups. It can not be considered that there are differences in the height and volume of the nipples between T3 and T2 patients after modified continuous external traction suspension, which also indicates the stability of this method in the treatment of nipple invagination. Conclusion: 1, the modified continuous external traction suspension is mild in the treatment of nipple invagination. Moderate nipple invagination was effective in all cases. The effect of modified continuous external traction suspension on mild nipple invagination and moderate nipple invagination was not significantly different. Maintenance therapy during consolidation period could effectively reduce congenital mild and moderate nipple invagination. The degree of nipple retraction after traction and suspension, In order to reduce the rate of nipple retraction and ensure the effect of suspending traction, the modified external traction suspension can be used to treat mild and moderate nipple invagination, which can effectively prevent the postoperative nipple retraction and maintain the stability of the nipple pulling out.
【学位授予单位】：西南医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R655.8

【参考文献】