皮瓣转移修复乳腺癌根治术后放射性溃疡的整形美容效果探讨

Plastic and Cosmetic Effects of Skin Flap Transfer in the Repair of Radioactive Ulcer after Radical Mastectomy for Breast Cancer

目的:探讨皮瓣转移修复乳腺癌根治术后放射性溃疡的整形美容效果。方法:选择2016年2月-2018年4月以乳腺癌根治术后放射性溃疡患者130例作为对象,按照随机数字表法分为对照组(n=65)和观察组(n=65)。对照组术后放射性溃疡患者采用药物干预治疗,观察组采用背阔肌肌皮瓣进行修复治疗,两组均进行3个月治疗,治疗完毕后对两组治疗效果进行评估。结果:观察组治疗后6个月有效率为89.23%,高于对照组的73.85%,差异有统计学意义(P<0.05)。治疗后6个月两组CRP、白细胞水平均低于治疗前,且观察组显著低于对照组,差异有统计学意义(P<0.05)。观察组创面愈合时间及治疗后1个月、2个月、3个月VAS评分均低于对照组,差异有统计学意义(P<0.05)。观察组治疗修复后3个月整体美观、修复部位色泽、修复部位外形、颜色不配评分均高于对照组,差异均有统计学意义(P<0.05)。结论:皮瓣转移修复乳腺癌根治术后放射性溃疡有助于提高临床疗效,降低炎症因子水平,减轻患者疼痛,可获得较高的整形美容效果,值得推广应用。

Objective To investigate the repair of skin flap and the cosmetic effect of radioactive ulcer after radical mastectomy for breast cancer.Methods One hundred and thirty patients with radiation ulcer after radical mastectomy were selected from February 2016 to April 2018.According to the random number table method,they were divided into the control group(n=65)and the observation group(n=65).In the control group,patients with radioactive ulcer were treated with drug therapy.The observation group was treated with latissimus dorsi muscle flap for repair.The two groups were treated for 3 months.The therapeutic effect of the two groups was evaluated after the treatment.Results The effective rate was 89.23%in the observation group 6 months after treatment,which was higher than that in the control group(73.85%),the difference was statistically significant(P<0.05).The levels of CRP and leucocyte in the two groups were lower than those before treatment 6 months after treatment,and the level of CRP and leucocyte in the observation group was significantly lower than that in the control group(P<0.05).The wound healing time and VAS scores of the observation group were lower than those of the control group at 1,2 and 3 months after treatment(P<0.05).After 3 months of treatment,the overall beauty,color,shape and color mismatch scores of the repaired parts in the observation group were higher than those in the control group(P<0.05).Conclusion The use of flap repair in patients with radiation ulcer after radical mastectomy can improve the clinical efficacy,reduce the level of inflammatory factors,reduce the pain of patients,and obtain a higher cosmetic and cosmetic effect.It is worthy of popularization and application.