不同皮瓣用于外侧象限乳腺癌保乳术中的效果比较
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摘要
目的比较不同皮瓣在外侧象限乳腺癌保乳术中的临床效果。方法收集2014年6月至2016年12月行外侧象限乳腺癌保乳术的74例乳腺癌患者的临床资料进行回顾性分析。将外侧象限乳腺癌保乳术中应用背阔肌肌皮瓣转移术的乳腺癌患者纳入A组,共36例;将外侧象限乳腺癌保乳术中应用侧胸壁脂肪筋膜肌肉皮瓣转移术的乳腺癌患者纳入B组,共38例。所有数据均采用SPSS 20.0统计软件进行分析,术中术后相关指标以■表示进行独立t检验;术后并发症发生率、乳房外观评价、肿瘤复发率及患者满意度,进行χ~2检验,以P<0.05表示差异具有统计学意义。结果两组患者均顺利完成外侧象限乳腺癌保乳术及皮瓣转移术,且术后无肿瘤复发。A组乳腺癌患者术中出血量较B组显著增多,手术时间明显延长,差异均具有统计学意义(P<0.05);两组患者的住院时间、术后并发症发生情况、术后乳房外观优良率及患者满意度相比,差异均无统计学意义(P>0.05)。结论两种皮瓣转移术应用于外侧象限乳腺癌保乳术中均安全可靠,临床效果可靠,值得在临床推广应用。
Objective To compare the clinical effect of different skin flap combined with the lateral quadrant breast conserving surgery. Methods The clinical data of 74 cases of lateral quadrant breast cancer patients treated with breast conserving surgery in our hospital from June 2014 to December 2016 were collected and retrospectively analyzed. 36 cases of quadrant breast cancer patients treatd with latissimus dorsi myocutaneous flap transfer surgery combined with breast conserving surgery were enrolled as A group. 38 cases of quadrant breast cancer patients treated with lateral thoracic fascia flap transfer surgery combined with breast conserving surgery were enrolled as B group. All data were analyzed by SPSS 20.0 statistical software. The intraoperative and postoperative related indicators were presented as ■ and examined by t test. The incidence of postoperative complications, breast appearance evaluation, recurrence rate and the patient satisfaction were compared between two groups by chi square test.Results All patients in the two groups were successfully completed the operation, no cases of tumor recurrence after operation was found. The intraoperative blood loss in the A group was significantly more than that in the B group, the operative time in the A group was significantly longer than that in the B group, all above had statistical difference(P<0.05). There was no statistical difference in the hospital stay, postoperative complications, breast appearance evaluation, recurrence rate and the patient satisfaction(P>0.05). Conclusion Both the two types of skin flap transfer surgery combined with the lateral quadrant breast conserving surgery are safe and reliable, and has the ideal clinical effect, which is worthy of clinical application.
Objective To compare the clinical effect of different skin flap combined with the lateral quadrant breast conserving surgery. Methods The clinical data of 74 cases of lateral quadrant breast cancer patients treated with breast conserving surgery in our hospital from June 2014 to December 2016 were collected and retrospectively analyzed. 36 cases of quadrant breast cancer patients treatd with latissimus dorsi myocutaneous flap transfer surgery combined with breast conserving surgery were enrolled as A group. 38 cases of quadrant breast cancer patients treated with lateral thoracic fascia flap transfer surgery combined with breast conserving surgery were enrolled as B group. All data were analyzed by SPSS 20.0 statistical software. The intraoperative and postoperative related indicators were presented as ■ and examined by t test. The incidence of postoperative complications, breast appearance evaluation, recurrence rate and the patient satisfaction were compared between two groups by chi square test.Results All patients in the two groups were successfully completed the operation, no cases of tumor recurrence after operation was found. The intraoperative blood loss in the A group was significantly more than that in the B group, the operative time in the A group was significantly longer than that in the B group, all above had statistical difference(P<0.05). There was no statistical difference in the hospital stay, postoperative complications, breast appearance evaluation, recurrence rate and the patient satisfaction(P>0.05). Conclusion Both the two types of skin flap transfer surgery combined with the lateral quadrant breast conserving surgery are safe and reliable, and has the ideal clinical effect, which is worthy of clinical application.
引文
[1] 王殊,杨后圃.乳腺癌改良根治术的适应证与手术规范[J/CD].中华普外科手术学杂志:电子版,2015,9(6):8-11.
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[4] 司婧,吴炅.乳腺癌患者乳房重建术后满意度评估方法比较[J/CD].中华乳腺病杂志(电子版),2017,11(6):361-364.
[5] 师金,梁迪,李道娟,等.全球女性乳腺癌流行情况研究[J].中国肿瘤,2017,26(9):683-690.
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[7] 张雪惠,陈月凤,薛小军,等.整形保乳术与常规保乳术治疗早期乳腺癌比较[J].现代仪器与医疗,2017,23(2):39-40,53.
[8] 李满秀,金立亭,龚益平.局部晚期乳腺癌乳房切除术后的创面覆盖[J/CD].中华普通外科学文献(电子版),2017,11(3):145-147.
[9] Kim JB, Kim DK, Lee JW, et al. The usefulness of pedicled perforator flap in partial breast reconstruction after breast conserving surgery in Korean women[J]. Arch Plast Surg,2018,45(1):29-36.
[10] 史京萍.带蒂背阔肌皮瓣在乳房重建手术中的应用[J].中国癌症杂志,2017,27(8):613-619.
[11] 吴以伦,史京萍,刘晓安.背阔肌肌皮瓣在保乳手术即刻整形中的应用[J].南京医科大学学报(自然科学版),2017,37(12):1638-1640.
[12] 李廷,王晨,徐达圆,等.四种皮瓣修复肘部皮肤软组织缺损[J/CD].中华损伤与修复杂志:电子版,2016,11(2):117-119.
[13] 洪士开,王圣应,刘松,等.侧胸壁脂肪筋膜肌肉瓣在乳腺癌术后即刻乳房成形中的应用[J].中国普通外科杂志,2016,25(5):693-698.
[14] 胡小戊,章乐虹,陈欣欣,等.部分背阔肌皮瓣或侧胸壁脂肪筋膜皮瓣在外侧象限乳腺癌保乳治疗中的应用[J].中国修复重建外科杂志,2017,31(9):1151-1152.
[2] 林小颜,罗建国,王恩礼,等.应用多方位腺体瓣一期修复乳腺癌保乳术后乳房缺损[J].广东医学,2017,38(12):1889-1890,1894.
[3] 李浩,王新杰,王娜.乳腺癌保乳术中胸外侧筋膜皮瓣在乳房缺损修复中的应用[J].实用癌症杂志,2017,32(8):1354-1357.
[4] 司婧,吴炅.乳腺癌患者乳房重建术后满意度评估方法比较[J/CD].中华乳腺病杂志(电子版),2017,11(6):361-364.
[5] 师金,梁迪,李道娟,等.全球女性乳腺癌流行情况研究[J].中国肿瘤,2017,26(9):683-690.
[6] 刘荫华,刘倩,辛灵,等.再谈乳腺癌前哨淋巴结活检与首诊Ⅳ期乳腺癌的外科干预[J/CD].中华普外科手术学杂志:电子版,2015,9(6):1-4.
[7] 张雪惠,陈月凤,薛小军,等.整形保乳术与常规保乳术治疗早期乳腺癌比较[J].现代仪器与医疗,2017,23(2):39-40,53.
[8] 李满秀,金立亭,龚益平.局部晚期乳腺癌乳房切除术后的创面覆盖[J/CD].中华普通外科学文献(电子版),2017,11(3):145-147.
[9] Kim JB, Kim DK, Lee JW, et al. The usefulness of pedicled perforator flap in partial breast reconstruction after breast conserving surgery in Korean women[J]. Arch Plast Surg,2018,45(1):29-36.
[10] 史京萍.带蒂背阔肌皮瓣在乳房重建手术中的应用[J].中国癌症杂志,2017,27(8):613-619.
[11] 吴以伦,史京萍,刘晓安.背阔肌肌皮瓣在保乳手术即刻整形中的应用[J].南京医科大学学报(自然科学版),2017,37(12):1638-1640.
[12] 李廷,王晨,徐达圆,等.四种皮瓣修复肘部皮肤软组织缺损[J/CD].中华损伤与修复杂志:电子版,2016,11(2):117-119.
[13] 洪士开,王圣应,刘松,等.侧胸壁脂肪筋膜肌肉瓣在乳腺癌术后即刻乳房成形中的应用[J].中国普通外科杂志,2016,25(5):693-698.
[14] 胡小戊,章乐虹,陈欣欣,等.部分背阔肌皮瓣或侧胸壁脂肪筋膜皮瓣在外侧象限乳腺癌保乳治疗中的应用[J].中国修复重建外科杂志,2017,31(9):1151-1152.