背阔肌皮瓣联合假体在乳腺癌改良根治术后乳房重建中的应用

Application of Latissimus Dorsi Flap Combined with Prosthesis in Breast Reconstruction after Modified Radical Mastectomy for Breast Cancer

目的研究背阔肌皮瓣联合假体在乳腺癌改良根治术后乳房重建中的应用。方法选取2013年6月～2017年6月本院收治的100例乳腺癌患者作为研究对象,通过抓阄法随机分为对照组和观察组,每组50例,其中对照组采用传统治疗方式,观察组患者采用背阔肌皮瓣联合假体治疗方式,使用焦虑评价量表(ASA)评价患者焦虑情况,比较两组患者对体型、社交方面的满意度,复发、转移和生存情况。结果观察组对术后焦虑情况、体型、社交方面的满意度分别为24.00%、50.00%、90.00%均优于对照组的86.00%、6.00%、26.00%,差异有统计学意义(P<0.05);观察组患者无肿瘤局部复发现象,无病理死亡,其中有1例患者术后第20个月出现骨转移现象。对照组患者中有4例出现远处转移,其中有1例患者仅为单纯远处转移,1例出现局部复发,同时伴随远处转移,剩余1例患者出现单纯局部复发,有2例患者死亡。两组患者术后肿瘤局部复发、病死率比较,差异无统计学意义(P>0.05)。结论针对乳腺癌改良根治术后乳房重建患者,采用背阔肌皮瓣联合假体方式进行治疗,临床疗效好且不增加肿瘤复发,患者满意度高。

Objective To study the application of latissimus dorsi flap combined with prosthesis in breast reconstruction after modified radical mastectomy.Methods 100 cases of breast cancer patients admitted to our hospital from June 2013 to June 2017 were randomly divided into control group and observation group,50 cases in each group.The control group was treated with traditional treatment.Patients in the group were treated with latissimus dorsi flap combined with prosthesis.The anxiety assessment scale(ASA)was used to evaluate the anxiety of the patients.The satisfaction of body shape and social aspects,recurrence,metastasis and survival were compared between the two groups.Results The satisfaction degree of postoperative anxiety,body type and social aspects of the observation group were 24.00%,50.00%,and 90.00%,respectively,which were better than 86.00%,6.00%,and 26.00%of the control group,the difference was statistically significant(P<0.05).There was no local tumor recurrence in the observation group,and no pathological death occurred.One of the patients had bone metastasis at the 20th month after surgery.In the control group,4 patients had distant metastases,1 patient had only distant metastasis,1 patient had local recurrence,and accompanied by distant metastasis.The remaining 1 patient had simple local recurrence and 2 patients died.There was no significant difference in the local recurrence and mortality between the two groups(P>0.05).Conclusion For patients with breast reconstruction after modified radical mastectomy for breast cancer,latissimus dorsi flap combined with prosthesis is used for clinical curative effect without increasing tumor recurrence and high patient satisfaction.