乳房内组织瓣治疗注射隆乳术后巨大移动性瘘道

Curative analysis of local tissue flaps in treatment for huge mobility fistula after breast augmentation

目的探索乳房内组织瓣治疗注射隆乳术后混合物移位的疗效。方法收集2006年1月至2014年3月78例注射隆乳术后聚丙烯酰胺水凝胶(PAAG)混合物移位患者的临床资料。按手术方法不同分为观察组和对照组,对照组39例将材料移位至胸腹壁,采取手术清洗刮去残腔,观察组39例在消除胸腹壁腔隙后,采用乳腺局部组织瓣的新设计治疗乳房内瘘道,封闭胸、腹壁通道。结果 78例患者术中均见PAAG在乳腺组织、腋窝、胸腹壁间隙广泛淤积,形成瘘道连通。观察组采用组织瓣治疗2周时分泌物减少82%,病变腔隙缩小80%,对照组未用组织瓣治疗引流物减少46%、病变面积缩小45%,2组比较差异具有统计学意义(P<0.01);4周时,对比2组愈合率,观察组组织瓣治疗明显优于对照组。结论乳房内PAAG混合物移位所形成的胸腹壁连通的慢性瘘道是造成胸腹壁内流动性包块与巨大空腔效果的主要原因;组织瓣可明显促进胸腹壁瘘道愈合。

Objective To investigate the efficacy of breast tissue flap cohesive treatment after breast augmentation injection mixture dis-placed.Methods A total of 78 patients with breast augmentation injection mixture polyacrylamide hydrogel（PAAG）shift in our hospital from January 2006 to March 2014 were divided into two groups according to different surgical methods,39 cases with the material shifted to abdominal wall in control group were treated by taking the cleaning operation to scrape residual cavity,39 patients in observation recieved new breast tissue flap design local treatment of breast fistula closed chest and abdominal wall channel after surgical elimination of the same abdom-inal wall cavities.Results The PAAG extensive deposition in the breast tissue,armpits,chest wall clearance were formed fistula communica-tion.The secretions of patients treated with tissue flap decreased 82%,the lacunar lesions reduced 80% after 2 weeks,while patients without tissue flap,the drain reduced 46%,the lesion size reduced 45%,the difference between the two groups was significant（P 〈0.01）.The heal-ing rate of tissue flap group was higher than that of conventional group after 4 weeks.Conclusion The PAAG mixture shifting formed fistula communication in the abdominal wall is the main reason of the mass flow and a huge cavity.Flap can significantly promote abdominal wall fis-tula healing.