腹壁下动脉穿支皮瓣乳房再造术后皮瓣淤血的研究进展

Research progress of venous congestion after deep inferior epigastric perforator flap breast reconstruction

腹壁下动脉穿支皮瓣乳房再造术能较好地矫正乳腺癌术后皮肤及组织的大量缺损,但术后出现皮瓣静脉淤血是较为常见的并发症之一。该文对这一问题进行了综述。出现皮瓣淤血的可能原因有静脉血栓、穿过中线的静脉交通支不足、深浅部交通支不足、吻合静脉的选择不当等。目前最主要的检测方法为临床检查,也可通过辅助检查来诊断。术前的血管评估尤为重要,预防淤血的具体方法各式各样,但主要以静脉增流为主。

Breast reconstruction with deep inferior epigastric perforator flap (DIEP flap)is an optimal technique for massive tissue defect after breast cancer surgeries.Venous congestion is one of the main complications and the probable reasons include thrombus,lack of ramus communicans across the midline or between deep and superficial system,improper choice of anastomotic vein,et al.Clinical examination is the main method,and other auxiliary tests can also be used.Preoperative vascular evaluation is of great importance.The venous superdrainage is current preventive measure for congestion.