内窥镜下离断胸廓内动脉穿支血管对乳沟重建假体隆乳术的研究

Study on breast cleavage remodeling and breast augmentation through transection of internal thoracic artery perforator vessel under endoscope

目的探讨内窥镜辅助下离断胸廓内动脉穿支血管对乳沟重建假体隆乳术的影响及临床效果。方法自2016年12月至2017年12月,将收治的120例(240侧)隆乳求美者按手术方式分为观察组和对照组。观察组行内窥镜辅助下离断胸廓内动脉穿支血管乳沟重建假体隆乳术64例(128侧);对照组行传统内窥镜辅助下假体隆乳术56例(112侧)。观察组在内窥镜辅助下离断胸大肌下缘起点,常规置入假体,然后比较两组术后的效果。结果两组求美者手术切口均甲级愈合。观察组术后随访满意率为98.43%(63/64),明显高于对照组89.29%(50/56),其差异具有统计学意义(P<0.05)。术者评价观察组和对照组乳房外观优良率分别为96.88%和85.71%;乳沟形态优良率分别为100%和75.00%;乳房活动度优良率分别为98.43%和89.29%;乳房手感优良率分别为98.43%和85.71%,其差异均有统计学意义(P<0.05)。结论采用内窥镜下离断胸廓内动脉穿支血管乳沟重建假体隆乳术,创伤较小、安全性较高、出血较少、乳房外形及乳沟形成良好,能提高求美者的满意度。

Objective To explore the clinical efficacy of transection of internal thoracic artery perforator vessel under endoscope in breast cleavage remodeling and breast augmentation.Methods From December 2016 to 2017,120 patients(240 sides)underwent breast augmentation were divided into observation group and control group according to the operation mode.In the observation group,the breast cleavage remodeling and breast augmentation through transection of internal thoracic artery perforator vessel under endoscope was performed in 64 patients(128 sides).In the control group,the traditional breast augmentation with endoscopic assistant was performed in 56 patients(112 sides).In the observation group,the starting point of lower margin of pectoralis major was cut off in the assistant of endoscope and the prosthesis was implanted.The postoperative efficacy of both groups was then compared.Results The operative incisions of both groups were grade A healing.The postoperative satisfaction rate of observation group was 98.43%(63/64),which was significantly higher than that of the control group of 89.29%(50/56).The difference was statistically significant(P<0.05).The excellent and good rate of the appearance of breast was 96.88%in the observation group and 85.71%in the control group;the morphology of breast cleavage was 100%and 75.00%;the activity of breast was 98.43%and 89.29%;the feeling of breast was 98.43%and 85.71%.The difference was statistically significant(P<0.05).Conclusion The transection of internal thoracic artery perforator vessel under endoscope for breast cleavage remodeling and breast augmentation has characteristics of less trauma,high safety and less bleeding.The appearance of breast and breast cleavage was good and patients’satisfaction was high.