乳腺癌改良根治术皮瓣厚度选择临床研究

Flap thickness selection in modified radical mastectomy:a clinical study

目的 探讨乳腺癌改良根治术中皮瓣厚度的选择，降低术后并发症发生率。方法 对2008年1~12月河南省人民医院乳腺外科78例行乳腺癌改良根治术的临床资料进行回顾性分析。将2008年1~6月的病人设为Haagensen皮瓣组，2008年7~12月的病人设为胸壁浅筋膜外组，对两组病人术中出血量、手术时间及术后并发症发生率进行对比研究。结果 胸壁浅筋膜外组的手术中出血量、手术时间、手术后总引流量及术后皮瓣坏死发生率均低于Haagensen皮瓣组，差异有统计学意义（P＜0.05）；手术后皮下积液发生率两组相比差异无统计学意义（P＝0.522）。结论 选择在紧贴胸壁浅筋膜浅层外侧的脂肪层中游离皮瓣，可有效降低乳腺癌根治术后并发症发生率。

Objective To explore the selection of flap thickness in modified radical mastectomy and reduce the incidence of postoperative complications. Methods The clinical data of 78 patients with breast cancer performed modified radical mastectomy between January 2008 and December 2008 in the Department of Breast Surgery, the People＇s Hospital of Henan Province were analyzed retrospectively. The patients were divided into C group （patients from January to June） and S group （patients from July to December）. Intraoperative blood loss, operation time and incidence of postoperative complication between two groups were compared. Results Intraoperative blood loss, operation time, postoperative total drainage volume and the incidence of flap necrosis in the S group were lower than those in the C group （P〈0.05）. There was no significant difference on the incidence of subcutaneous fluid between two groups（P=0.522）. Conclusion Dissociating flap close to the lateral chest wall superficial fascia superficial fat layer can reduce the postoperative complications of radical mastectomy effectively.