保留皮肤的乳腺癌根治术后即时背阔肌皮瓣乳房再造术的临床疗效分析

Therapeutic analysis of breast reconstruction with extended latissimus dorsi musculocutaneous flap after skin-sparing radical mastectomy of breast cancer

目的探讨保留皮肤的乳腺癌根治术后背阔肌皮瓣乳房再造术在乳腺癌患者中的应用效果。方法 90例乳腺癌患者随机分为观察组(n=45)与对照组(n=45),对照组给予乳腺癌根治术,观察组在对照组基础上采用即时背阔肌皮瓣乳房再造术,观察2组患者手术情况、术后体型恢复、心理状态及生活质量。结果观察组术后乳房再造均获成功,外形优良率88.9%,显著高于对照组(P<0.01);焦虑发生率显著低于对照组(P<0.01),对体型及社交的满意率显著高于对照组(P<0.01);2组患者在术后引流时间、术后开始综合治疗的时间、总住院时间及术后并发症发生率等方面均无显著差异(P>0.05)。结论背阔肌皮瓣在保留皮肤的乳腺癌根治术后患者乳房再造术中的应用可使患者获得满意的形体恢复,使之能够更好重新融入社会,提高其生活质量。

Objective To study the clinical effects of breast reconstruction with extended latissimus dorsi musculocutaneous flap after skin - sparing radical mastectomy of breast cancer. Methods Ninety patients with breast cancer were randomly divided into observation group （ n = 45） and control group（ n = 45）. The control group was treated with radical mastectomy only, and the observation was treated with breast reconstruction with the extended latissimus dorsi musculocu- taneous flap based on the control group. Results cessful breast reconstruction. The excellent rate All patients in the observation group received suc- of breast shape was 88.9 %, significantly higher than that in the control group （P 〈 0.01）, the incidence of anxiety was significantly lower than that of the control group（P 〈 0.01）, and satisfaction rate on breast shape and socialization were signifi- cantly higher than that of the control group（P 〈0.01）. But no significant differences in drainage time, time to start comprehensive treatment, and total length of postoperative hospital stay between the two groups were observed （P 〉 0.05）. Conclusion Breast reconstruction with the extended latissimus dorsi musculocutaneous flap after skin- sparing radical mastectomy of breast cancer has important meanings in recovering female body shape, increasing the self- confidence in social activi- ties and the quality of life