应用背阔肌皮瓣进行乳房重建对肩关节功能的影响

Effect of latissimus dorsi flap on function of shoulder joints while in breast reconstruction

目的:探讨应用背阔肌皮瓣进行乳房重建术对肩关节的运动范围及相关并发症的影响。方法:分析52例乳腺癌手术病例,其中29例仅施行改良根治术为对照组,另外23例施行改良根治术联合背阔肌皮瓣进行乳房重建为实验组,术后随访1,3,6,12个月分别评估肩关节的运动范围、疼痛、组织粘连、疤痕扩大和腋窝网络综合征情况。结果:两组患者的肩关节运动范围在术后1个月内均减少40%,而后逐渐恢复。应用背阔肌皮瓣进行乳房重建与肩关节的外展和屈曲能力无关,疤痕扩大和组织粘连的发生率较低。结论:应用背阔肌皮瓣进行乳房重建不会进一步影响肩部运动,组织粘连的发生率更低。

Objective： To evaluate the effects of latissimus dorsi flap on shoulder range of motion and other complications in breast reconstruction. Methods： In 52 cases of mastectomies,29 patients received mastectomy surgery,and anothor 23 patients received mastectomy combined with breast reconstruction with latissimus dorsi flap. Shoulder range of motion, pain, tissue adhesion, scar enlargement, and web syndrome among patients were respectively assessed at 1,3,6,and 12 months＇ follow-up after surgery.Results： Shoulder range of motion in patients of both groups decreased 40 percent 1 month after surgery,then gradually recovered during follow-ups. Over time,the latissimus dorsi flap was not associated with the restriction of flexion or abduction of shoulder joints,and occurrence of scar enlargement and tissue adhesion was less common in the latissimus dorsi flap group. Conclution： The research shows that breast construction with latissimus dorsi flap has little effect on shoulder functions and is associated with a lower incidence of tissue adhesion.