双环形切口真皮帽法与垂直切口双蒂瓣法巨乳缩小术的对比研究
发布时间：2018-12-19 09:50
【摘要】：目的：选取常用乳房缩小术术式中的两种术式：双环形切口真皮帽法巨乳缩小整形术和垂直切口垂直双蒂瓣法巨乳缩小整形术,在手术方法、术后效果及术后满意度等方面进行对比研究,分析两种术式术后并发症的发生原因及如何处理预防。方法：选取乳房肥大症患者相关病例30例,年龄26-44岁,已婚已育20例,未婚未生育10例。将30例患者分为A、B两组,分别应用上述两种术式进行对比分析,A组15例患者应用双环形切口真皮帽法巨乳缩小整形术;B组15例患者应用垂直切口双蒂瓣法巨乳缩小整形术。根据患者的术前临床症状资料和乳房数据进行术前设计,术中按照术前设计精准操作,认真做好术后护理、观察,及时发现处理并发症。观察两组术前设计、术中操作、术后乳房形态、并发症及切口瘢痕以及术后恢复情况。结果：A组15例应用双环切口真皮帽法巨乳缩小整形术的患者中,术后3例单侧乳晕局部出现水泡,变黑,经及时处理数日后好转、恢复。4例出现切口瘢痕增生,术后患者切口因荷包缝合所到切口皱褶明显,未出现脂肪液化,血清肿,血肿等并发症。术后6-12个月随访,患者双侧乳房形态基本对称,乳房充盈、饱满,乳头乳晕感觉良好,切口瘢痕恢复良好,个别有瘢痕增生现象的患者在术后6个月后瘢痕增生现象也逐渐好转。术后双乳手感自然,乳晕边缘切口皱褶纹理瘢痕逐渐减轻、松懈。术前出现的因乳房过大和过重所产生的症状被良好的改善。患者的生活质量得以明显提高,最初的设计形态决定最后的手术效果。乳腺组织去除的多少决定术后乳房的大小。B组15例应用垂直切口垂直双蒂瓣法巨乳缩小整形的患者术,出现术后切口延迟愈合1例,出现三角尖瓣皮肤坏死1例,出现切口瘢痕增生1例,两组术式中均未出现脂肪液化,血清肿,血肿等并发症。在术后6-12个月进行了术后随访,患者双侧乳房形态大致对称,乳房充盈、饱满,乳头乳晕感觉良好,切口瘢痕恢复良好,个别患者在术后3个月有瘢痕增生现象,在给予注射瘢痕软化药物后逐渐好转。术后双乳手感自然,三角尖瓣切口处瘢痕略微明显。术前出现的因乳房过大所伴随的症状得到良好的改善。生活质量得以明显提高。结论：双环形切口真皮帽法巨乳缩小术和垂直切口双蒂巨乳缩小整形术术后效果均有良好改善,两种术式都有各自的优缺点,并发症发生的几率无太大差异,早期的并发症主要为血肿。双环形切口真皮帽法巨乳缩小整形术主要适用于轻、中度的乳房缩小和矫正乳房下垂,术后切口瘢痕隐蔽,术后效果美观,满意度高。但手术设计要求较高,术后易出现血肿,影响乳头、乳晕的敏感性。垂直切口双蒂瓣法巨乳缩小整形术适用于中、重度巨乳症患者,术后效果良好但瘢痕较明显。
[Abstract]:Objective: to select two common breast reduction procedures: double ring incision dermis cap surgery and vertical double pedicle flap mammoplasty. The causes of postoperative complications and how to deal with the prevention of complications were analyzed and compared in terms of postoperative effect and postoperative satisfaction. Methods: 30 cases of breast hypertrophy, aged 26-44 years, were selected. 20 cases were married and 10 cases were unmarried. Thirty patients were divided into two groups: group A (n = 15) and group A (n = 15). In group B, 15 patients were treated with double pedicle flap vertical incision for mammoplasty. According to the clinical symptom data and breast data of the patients, the preoperative design was performed accurately during the operation, the postoperative nursing care was carefully done, and the complications were found and dealt with in time. The preoperative design, intraoperative operation, breast morphology, complications, incision scar and postoperative recovery were observed in both groups. Results: in group A, blisters were found in 3 cases of unilateral areola, which were improved and recovered after a few days of treatment, and 4 cases appeared scar hyperplasia in the incision, among the 15 cases in group A who were treated with double ring incision dermis cap method for large mammary reduction and plastic surgery, 3 cases had local blisters in the unilateral areola after operation, and 4 cases had scar hyperplasia in incision. There were no complications such as fat liquefaction, serum swelling, hematoma and so on. The patients were followed up 6-12 months after operation. The bilateral breasts were basically symmetrical, the breasts were full and full, the nipple areola felt well, and the scar of the incision recovered well. Some patients with scar hyperplasia gradually improved after 6 months after operation. After the operation, the feeling of double breasts was natural, and the wrinkle scar was gradually alleviated and relaxed at the edge of areola. Preoperative symptoms of oversize and overweight were well improved. The patient's quality of life was significantly improved, and the initial design shape determined the final outcome of the operation. The size of breast was determined by the removal of mammary tissue. In group B, 15 patients underwent vertical double pedicle flap surgery, 1 patient had delayed healing of incision, and 1 patient had skin necrosis of triangle tip flap. Incision scar hyperplasia occurred in 1 case. There were no complications such as fat liquefaction, serum swelling and hematoma in both groups. The patients were followed up 6-12 months after operation. The bilateral breasts were roughly symmetrical, the breasts were full and full, the nipple areola felt well, the incision scar recovered well, and some patients had scar hyperplasia at 3 months after operation. After the injection of scar softening drug gradually improved. After operation, both breasts feel natural and the scar at the incision of triangle flap is slightly obvious. Preoperative symptoms associated with breast enlargement were well improved. The quality of life has improved significantly. Conclusion: the results of double ring incision and vertical incision double pedicle mammoplasty have good improvement, both of them have their own advantages and disadvantages, and there is no significant difference in the incidence of complications. The main early complication was hematoma. Double ring incision dermis cap method is mainly suitable for small and moderate breast reduction and correction of breast prolapse. The incision scar is hidden after operation, the effect is beautiful, and the satisfaction is high. But the operation design is high, the postoperative hematoma is easy to appear, which affects the sensitivity of nipple and areola. Vertical incision double pedicle flap surgery is suitable for moderate and severe mammoplasty. The effect is good but the scar is obvious.
【学位授予单位】：大连医科大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R655.8
[Abstract]:Objective: to select two common breast reduction procedures: double ring incision dermis cap surgery and vertical double pedicle flap mammoplasty. The causes of postoperative complications and how to deal with the prevention of complications were analyzed and compared in terms of postoperative effect and postoperative satisfaction. Methods: 30 cases of breast hypertrophy, aged 26-44 years, were selected. 20 cases were married and 10 cases were unmarried. Thirty patients were divided into two groups: group A (n = 15) and group A (n = 15). In group B, 15 patients were treated with double pedicle flap vertical incision for mammoplasty. According to the clinical symptom data and breast data of the patients, the preoperative design was performed accurately during the operation, the postoperative nursing care was carefully done, and the complications were found and dealt with in time. The preoperative design, intraoperative operation, breast morphology, complications, incision scar and postoperative recovery were observed in both groups. Results: in group A, blisters were found in 3 cases of unilateral areola, which were improved and recovered after a few days of treatment, and 4 cases appeared scar hyperplasia in the incision, among the 15 cases in group A who were treated with double ring incision dermis cap method for large mammary reduction and plastic surgery, 3 cases had local blisters in the unilateral areola after operation, and 4 cases had scar hyperplasia in incision. There were no complications such as fat liquefaction, serum swelling, hematoma and so on. The patients were followed up 6-12 months after operation. The bilateral breasts were basically symmetrical, the breasts were full and full, the nipple areola felt well, and the scar of the incision recovered well. Some patients with scar hyperplasia gradually improved after 6 months after operation. After the operation, the feeling of double breasts was natural, and the wrinkle scar was gradually alleviated and relaxed at the edge of areola. Preoperative symptoms of oversize and overweight were well improved. The patient's quality of life was significantly improved, and the initial design shape determined the final outcome of the operation. The size of breast was determined by the removal of mammary tissue. In group B, 15 patients underwent vertical double pedicle flap surgery, 1 patient had delayed healing of incision, and 1 patient had skin necrosis of triangle tip flap. Incision scar hyperplasia occurred in 1 case. There were no complications such as fat liquefaction, serum swelling and hematoma in both groups. The patients were followed up 6-12 months after operation. The bilateral breasts were roughly symmetrical, the breasts were full and full, the nipple areola felt well, the incision scar recovered well, and some patients had scar hyperplasia at 3 months after operation. After the injection of scar softening drug gradually improved. After operation, both breasts feel natural and the scar at the incision of triangle flap is slightly obvious. Preoperative symptoms associated with breast enlargement were well improved. The quality of life has improved significantly. Conclusion: the results of double ring incision and vertical incision double pedicle mammoplasty have good improvement, both of them have their own advantages and disadvantages, and there is no significant difference in the incidence of complications. The main early complication was hematoma. Double ring incision dermis cap method is mainly suitable for small and moderate breast reduction and correction of breast prolapse. The incision scar is hidden after operation, the effect is beautiful, and the satisfaction is high. But the operation design is high, the postoperative hematoma is easy to appear, which affects the sensitivity of nipple and areola. Vertical incision double pedicle flap surgery is suitable for moderate and severe mammoplasty. The effect is good but the scar is obvious.
【学位授予单位】：大连医科大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R655.8
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