乳房再造同期上肢淋巴水肿治疗和预防的现状及趋势

Current status and trends of breast reconstruction with simultaneously treatment and prevention ofupper limb lymphedema

乳腺癌是我国女性发病率最高的恶性肿瘤，乳腺癌外科治疗后遗留的乳房缺损、胸壁畸形、腋窝凹陷及上肢淋巴水肿等问题，对患者的身心健康和生活质量造成了严重影响。该文介绍了乳腺癌术后乳房再造同期上肢淋巴水肿的预防和治疗方法，包括背阔肌肌皮瓣／腹部皮瓣转移同时携带血管化淋巴结、淋巴管吻合、淋巴管．静脉吻合、自体脂肪移植填充、患肢脂肪抽吸等手术疗法，以及保守疗法和术中影像技术的应用。对其临床应用的现状、趋势和优缺点进行介绍和评价。

Breast cancer is one of the highest incidence of all malignant tumors of women in China now. Surgical treatment of breast cancer always leaves patients with problems, such as defect of breast, deformity of chest wall, sunken of axilla and upper limb lymphedema, making great influences on patients＇ physical and mental health and their quality of life. This review mainly focuses on the current status and trends of breast reconstruction with simultaneously prevention and treatment of upper limb lymphedema, by introducing surgical methods such as breast reconstruction with latissimus dorsi myocutaneous flap ! abdominal flap with vascularized lymph nodes transfer, lymph vessel anastomosis, lymph vessel and vein venous anastomosis, fat grafting and liposuction, as well as the image examinations in surgery and the conservative treatment of upper limb lymphedema.