摘要
目的分析应用不同蒂进行乳房缩小整形术的适应证、手术效果及其优缺点。方法2003年8月～2005年12月,我中心分别采用中央乳腺蒂、内侧真皮乳腺蒂、外下侧真皮乳腺蒂、下侧真皮乳腺蒂进行乳房缩小整形术共78例156侧,术后分别对乳头乳晕血运情况、患者对外形的满意度、乳头乳晕感觉的保留及切除组织量等进行调查。结果随访时间为术后即刻到1.5年,采用乳腺蒂以及内侧蒂组乳头乳晕无1例出现血运障碍;应用乳腺蒂及外下侧蒂的患者术后对外形满意度较高,分别为96.7%和87.5%;乳腺蒂组术后乳头乳晕感觉保留比例在各组中最高;真皮乳腺下蒂切除组织量最大,平均为753.3g。结论乳房缩小整形术中蒂的选择与乳房肥大程度、乳头乳晕感觉的保留及乳房的形态重塑有很大的关系。对于轻度乳房肥大,乳腺蒂无疑是最佳的选择;对于中度乳房肥大,应根据切口的设计选择下蒂或外下蒂;而对于较重度乳房肥大,则以下蒂为首选。
Objective To investigate the efficacy,indication,advantages and disadvantages of pecicles for reduction mammplasty.Methods 78 cases with hypertrophy of breast underwent reduction mammplasty using various pedicles.Based on the follow～up of the cases,the appearance,sensory retention of nipple and areola complex,blood supply were evaluated.Results The postoperative result of lateral pedicle,lateral inferior pedicle and mammary gland pedicle were satisfactory in terms of blood supply,nipple～areola sensory retention and amount of mammary tissue removed.Conclusion The choice of pedicle direction can be independent of the skin resection.There is a relationship exist between pedicle direction and retention of sensation or amount of mammary tissue removed.The inferior pedicle and later inferior pedicle allows better shaping as well as maintaining good sensation.A pedicle should be selected according to the extent of breast hypertrophy and request of the patients.
