自体耳软骨游离移植在重度乳头内陷矫治中的应用

Autogenous auricular cartilage free transplantation in the treatment of severe inverted nipple

目的观察自体耳软骨游离移植矫治重度乳头内陷的临床应用及其效果。方法将2014年1月至2020年1月收治的重度乳头内陷患者120例,采取随机数字法分成对照组和观察组,各60例。其中观察组患者采用自体耳软骨游离移植矫治重度乳头凹陷,对照组采用皮瓣法、缝合法、物理牵引法矫正重度乳头凹陷。根据手术时间、手术创伤程度(失血、创面直径)、住院时间、术后乳头形状和功能改善程度、患者的满意度,及术前、术后生活质量进行综合评价。结果观察组患者手术时间、手术失血量、创面直径、住院时间少于对照组,差异有统计学意义(P均<0.01)。观察组患者术后乳头形状及功能改善程度评分高于对照组,差异有统计学意义(P均<0.01)。观察组患者对治疗过程、术后功能、愈后瘢痕的满意度评分均高于对照组,差异有统计学意义(P均<0.01)。术后两组患者世界卫生组织生存质量简表(WHOQOL-BREF)评分较术前均显著升高,其中观察组显著高于对照组(P均<0.01)。结论在重度乳头内陷的矫治中,采取自体耳软骨游离移植矫治,可明显缩短患者的手术时间,减少手术对患者的创伤程度,有效缩短住院时间,提升患者术后乳头形状及功能的改善程度与患者的满意度,效果理想。

Objective To observe the clinical application of autogenous auricular cartilage free transplantation in the treatment of severe inverted nipple.Methods A total of 120 patients with severe inverted nipple treated from January 2014 to January 2020 were randomly divided into control group and experimental group(n=60,each).The autogenous auricular cartilage free transplantation was performed in experimental group,and the skin flap,suture and physical traction were conducted in control group.The operation time,degree of surgical trauma(blood loss,wound size),hospital stay,improvement of nipple shape and function after operation,satisfaction of patients and quality of life were comprehensively evaluated in two groups.Results Compared with control group,the operation time,blood loss,wound size and hospital stay significantly decreased in experimental group(all P<0.01).The improvement scores of nipple shape and function,the satisfaction scores of treatment process,postoperative function and scar healing in experimental group were significantly higher than those in control group(all P<0.01).After operation,the World Health Organization Quality of life Instrument-Short Form(WHOQOL-BREF)scores were significantly higher than those before operation in two groups and were significantly higher in experimental group than those in control group(all P<0.01).Conclusion In the treatment of severe inverted nipple,free transplantation of autogenous auricular cartilage can significantly shorten the operation time,reduce the trauma degree of operation,the hospitalization time,and increase the improvement degree of nipple shape and function and the satisfaction score of the patients,the effect is ideal.