123例肿胀技术硅凝胶假体隆乳术临床分析
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摘要
目的:探讨肿胀技术下经腋窝入路行胸大肌后硅凝胶假体隆乳术的优缺点和可行性。
方法:总结2006年9月至2010年2月我院收治的120例乳房发育不良和3例乳房聚丙烯水凝胶注射物取出术后患者的临床病例资料和随访结果。所有病人均采用腋窝入路肿胀技术行胸大肌后硅凝胶假体隆乳术,对手术满意度和术后近期、远期并发症进行系统性回顾分析和总结。
结果:采用该手术方法的123例病人中术后近期发现假体上移2例(3只乳房,1.6%),血肿1例(1只乳房, 0.8%),无菌性静脉炎(Mender氏病)3例,其中胸壁2例,上臂内侧1例(2.4%);远期假体上移1例(1只乳房,0.5%),双侧乳房注射物取出术后假体置入,术后发生包膜挛缩,经手术剥除包膜后再次包膜挛缩1例(2只乳房,1.1%)。术后一周对隆乳效果满意者117例(满意率95.1%)。92例随访随访3个月-2年,满意者90例(满意率97.8%)
结论:本手术方法并发症少,是安全、有效,值得推广的隆乳术式。
Objective: To make an approach of the relative merits and feasibility of augmention mammaplasty with silicone implant and tumescent technique in the pectoral muscle back interspace from axillary fossa incision .
Methods: Clinical cases data and follow-up results were summarized in 120 cases with depauperate breast and 3 cases with the operation of dislodging injectant poly propylene hydrogel in the hospital from September 2006 year to Finebruary 2010 year .All patients had been operated on augmention mammaplasty with silicone implant and tumescent technique in the pectoral muscle back interspace from axillary fossa incision. Their satisfactory grades and short-term and long-term complications following the operation had been analyzied restrospectively and summarized systematically.
Result : With short-term complications following the operation ,there were two patients with prosthesis breast moving up of 123 cases used this method(3 breasts, 1.6%), 1case of haematoma ( 1 breast ,0.8%), 2 cases in chest wall and 1cases in upper arm wall in the 3 case of sterility phlebitis (Mender disease ) ( 2.4%); With long-term complications following the operation, there was 1case of prosthesis moving up (1 breast ,0.5%),1case of two breasts with dislodging injectant and implanting prosthesis ,generating amicula contracture and amicula contracture again after divest amicula(2 breasts ,1.1%).117 patients were satisfactory with breast augmention after the operation in one week(satisfaction rate 95.1%). In 92 cases follow-up from three months to two years, 91 patients were satisfactory with breast augmention finally(satisfaction rate 97.8%).
Conclusion : This method with less imcomplications,safe and effectivity is worth spreading
方法:总结2006年9月至2010年2月我院收治的120例乳房发育不良和3例乳房聚丙烯水凝胶注射物取出术后患者的临床病例资料和随访结果。所有病人均采用腋窝入路肿胀技术行胸大肌后硅凝胶假体隆乳术,对手术满意度和术后近期、远期并发症进行系统性回顾分析和总结。
结果:采用该手术方法的123例病人中术后近期发现假体上移2例(3只乳房,1.6%),血肿1例(1只乳房, 0.8%),无菌性静脉炎(Mender氏病)3例,其中胸壁2例,上臂内侧1例(2.4%);远期假体上移1例(1只乳房,0.5%),双侧乳房注射物取出术后假体置入,术后发生包膜挛缩,经手术剥除包膜后再次包膜挛缩1例(2只乳房,1.1%)。术后一周对隆乳效果满意者117例(满意率95.1%)。92例随访随访3个月-2年,满意者90例(满意率97.8%)
结论:本手术方法并发症少,是安全、有效,值得推广的隆乳术式。
Objective: To make an approach of the relative merits and feasibility of augmention mammaplasty with silicone implant and tumescent technique in the pectoral muscle back interspace from axillary fossa incision .
Methods: Clinical cases data and follow-up results were summarized in 120 cases with depauperate breast and 3 cases with the operation of dislodging injectant poly propylene hydrogel in the hospital from September 2006 year to Finebruary 2010 year .All patients had been operated on augmention mammaplasty with silicone implant and tumescent technique in the pectoral muscle back interspace from axillary fossa incision. Their satisfactory grades and short-term and long-term complications following the operation had been analyzied restrospectively and summarized systematically.
Result : With short-term complications following the operation ,there were two patients with prosthesis breast moving up of 123 cases used this method(3 breasts, 1.6%), 1case of haematoma ( 1 breast ,0.8%), 2 cases in chest wall and 1cases in upper arm wall in the 3 case of sterility phlebitis (Mender disease ) ( 2.4%); With long-term complications following the operation, there was 1case of prosthesis moving up (1 breast ,0.5%),1case of two breasts with dislodging injectant and implanting prosthesis ,generating amicula contracture and amicula contracture again after divest amicula(2 breasts ,1.1%).117 patients were satisfactory with breast augmention after the operation in one week(satisfaction rate 95.1%). In 92 cases follow-up from three months to two years, 91 patients were satisfactory with breast augmention finally(satisfaction rate 97.8%).
Conclusion : This method with less imcomplications,safe and effectivity is worth spreading
引文
[1]杨怡佳,任从才,姜海洋,陈剑铭隆乳术麻醉效果观察中国美容医学2005年8月第14卷第4期Chinese Journal of Aesthetic Medicine. Aug.2005.Vol.14.No.4
[2]黄文君,陈振雨,张维娜,苏毅鹏,朱月华肿胀麻醉技术在隆乳术中的应用齐鲁医学杂志2009年8月第24卷第4期.
[3]李蕾,赵萍,赵波胸大肌后间隙肿胀麻醉隆乳术436例临床和实验医学杂志2007年10月第6卷第10期
[4]伟强,陈石海,殷国前,等.肿胀麻醉技术在假体隆乳术中的应用[J ] .中华整形外科杂志, 2007 ,23 (3) :2712272.
[5] CHANG D W. Textured surface breast implants in the preventionof capsular contracture among breast augmentation patients : A meta- mnalysis of randomized controlled trials [J ] . Breast Diseases : AYear Book Quarterly , 2007 ,18 (1) :102 - 102.
[6] MA S L , GAO W C. Capsular contracture in breast augmentation with textured versus smooth mammary implants : a systematic re2view[J ] . Zhonghua Zheng Xing Wai Ke Za Zhi , 2008 ,24 (1) :71 -74
[7]滕利,凌詒淳,庄强,等.国产小型模拟硅凝胶乳房假体所致组织学反应得实验研究[ J ].中华整形烧伤外科杂志, 1994, 10 (5) : 356- 357, 410.
[8]张宝誉腋窝顶部切口硅胶假体隆乳术44例体会临床和实验医学杂志2009年6月第8卷第6期
[9]吴一,李伟,邓颖胸大肌下假体隆乳术技术改进中国美容医学2006年5月,第15卷第5期Chinese Journal of Aesthetic Medicine.May.2006. Vol.15. No.5
[10]田田,李春英乳房下皱襞的结构特点及其在隆乳术中的应用医学综述2008年2月第14卷第4期Medical Recapitulate. feb 2008. Vol.14. No.4
[11]楼晓莉,宋建星隆乳术后包膜挛缩研究进展中国美容整形外科杂志2008年12月第19卷第6期Chin J Aesth Plast Surg , Dec 2008 Vol. 19 No. 6
[12] WORSEG A , KUZBARI R , TAIRY CH G, et al. Long term re2sults of inflatable mammary implants [J ] . Br J Plast Surg , 1995
[13]徐青丽,陈红岚,郑雪芬.红外线照射预防外周中心静脉置管术后无菌性静脉炎的研究Chin J Nosocomiol Vol.18.No.1.2008.
[1 ] Malata CM, Feldberg L , Coleman DJ , etc. Textured or smooth implants for breastaugmentation ? Three year follow2up of aprospective randomized controlled trial [J ] . British Journal of Plastic Surgery , 1997 , 50 : 99 - 105. [2 ] Smahel J , Hurwitz PJ , Hurwitz N. SoftTissue response to textured silicone implantsin an animal experiment [J ] . Plast ReconstrSurg , 1993 , 92 (3) : 474.
[3] Barone FE , Perry L , Keller T, etc. Thebiomechanical and histopathologic effects ofsurface texturing with silicone and polyurethane in tissueimplantation and expan2sion [J ] . Plast Reconstr Surg , 1992 , 90 : 77. [4 ] Alain M. Danino , Philippe Basmacioglu , Seiko Saito , etc. Comparison of the Capsu2lar Response to the Biocell RTV and Mentor1600 Siltex Breast Implant Surface Texturing : A Scanning Electron Microscopic Study [J ] . Plastic and Reconstructive Surgery , 2001 , 108 (7) : 2047 - 52.
[5]张波,杨川,余力1隆乳术乳房假体容积的测算[J ] .实用美容整形外科杂志, 1998 , 9 (6) : 288 - 901
[6]张恒术,沈为民,薛斌,等1隆乳术前后体表测量参数的比较[J ] . 1999 , 24 (2) : 159 - 611 [7 ] SPEAR S L. Breast augmentation with reduced - height anatomic im2plants : the pros and cons[J ] , Clin Plast Surg , 2001 ,28 (3) :561 - 565. [ 8 ]宋儒耀,方彰林1美容整形外科学[M] .北京出版社11992年8月第2版. [ 9 ]赵耀中,林子豪,陈敏亮1经乳晕切口不损伤乳腺腺体的隆乳术[J ] .实用美容整形外科杂志, 1996 , 7 (6) : 300 -21
[10]陆文鹏,施耀明1改良的适应松垂小乳症的隆乳术[J ] .实用美容整形外科杂志, 1996 , 7 (5) : 247 - 91
[11]吴自萍,傅敏刚,叶琳,等1改进剥离范围在提高隆乳外形美中的应用[J ] .中华整形烧伤外科杂志, 1998 , 14 (2) : 124 - 61
[12]崔海燕,陈锦安肿胀麻醉下腋窝切口偏心圆隆乳术
[13] Asplund O. Capsular contracture in siliconegel and saline2filled breast implantsafter re2construction [ J ] . Plast Reconstr Surg , 1984 , 73 : 270 - 5.
[14] Gylbert L , Asplund O , Jurell G. Capsularcontracture after breast reconstruction withsilicone2gel and saline2filled implants : a 62ywar follow2up [ J ] . Plast Reconstr Surg , 1990 , 85 : 373 - 7.
[15] CHANG D W. Textured surface breast implants in the preventionof capsular contracture among breast augmentation patients : A meta- mnalysis of randomized controlled trials [J ] . Breast Diseases : AYear Book Quarterly , 2007 ,18 (1) :102 - 102.
[16] MA S L , GAO W C. Capsular contracture in breast augmentationwith textured versus smooth mammary implants : a systematic re2view[J ] . Zhonghua Zheng Xing Wai Ke Za Zhi , 2008 ,24 (1) :71 -74.
[17] WORSEG A , KUZBARI R , TAIRYCH G, et al. Long term re2sults of inflatable mammary implants [J ] . Br J Plast Surg , 1995 , 48 :18.
[18]马显杰,鲁开化,艾玉峰.乳晕切口胸大肌后间隙隆乳纤维包膜挛缩的成因及防治[ J ] .实用美容整形外科杂志, 1999 , 10 (5) :225 - 226.
[19]张东波.隆乳术后包膜挛缩外伤致血肿机化一例[J ] .中国美容医学, 2008 ,17 (1) :125 - 125. [20 ]袁伟伟,罗锦辉.隆乳术后纤维包膜挛缩机理的实验研究[J ] .第一军医大学学报, 1999 ,19 (1) :46 - 48. [3 ]
[21] PAJ KOS A , DEVA A K, VICKERY K, et al. Detection of sub2clinical infection in significant breast implant capsules [ J ] . PlastReconstr Surg , 2003 ,111 (5) :1605 - 1611
[22] Brinton , Louise A , Lubin , Jay H , CayBurich , Mary , etc. Mortality among Aug2mentation Mammoplasty Patients [J ] . Epi2 demiology , 2001 , 12 (3) : 321- 6.
[23] Mclaughlin JF , Nyren O , Blot WJ , etc. Cancer risk among women with cosmeticbreast : a population2based cohort study inSweden [ J ] . J Natl Cancer Inst , 1998 , 90 : 156 - 8.
[2]黄文君,陈振雨,张维娜,苏毅鹏,朱月华肿胀麻醉技术在隆乳术中的应用齐鲁医学杂志2009年8月第24卷第4期.
[3]李蕾,赵萍,赵波胸大肌后间隙肿胀麻醉隆乳术436例临床和实验医学杂志2007年10月第6卷第10期
[4]伟强,陈石海,殷国前,等.肿胀麻醉技术在假体隆乳术中的应用[J ] .中华整形外科杂志, 2007 ,23 (3) :2712272.
[5] CHANG D W. Textured surface breast implants in the preventionof capsular contracture among breast augmentation patients : A meta- mnalysis of randomized controlled trials [J ] . Breast Diseases : AYear Book Quarterly , 2007 ,18 (1) :102 - 102.
[6] MA S L , GAO W C. Capsular contracture in breast augmentation with textured versus smooth mammary implants : a systematic re2view[J ] . Zhonghua Zheng Xing Wai Ke Za Zhi , 2008 ,24 (1) :71 -74
[7]滕利,凌詒淳,庄强,等.国产小型模拟硅凝胶乳房假体所致组织学反应得实验研究[ J ].中华整形烧伤外科杂志, 1994, 10 (5) : 356- 357, 410.
[8]张宝誉腋窝顶部切口硅胶假体隆乳术44例体会临床和实验医学杂志2009年6月第8卷第6期
[9]吴一,李伟,邓颖胸大肌下假体隆乳术技术改进中国美容医学2006年5月,第15卷第5期Chinese Journal of Aesthetic Medicine.May.2006. Vol.15. No.5
[10]田田,李春英乳房下皱襞的结构特点及其在隆乳术中的应用医学综述2008年2月第14卷第4期Medical Recapitulate. feb 2008. Vol.14. No.4
[11]楼晓莉,宋建星隆乳术后包膜挛缩研究进展中国美容整形外科杂志2008年12月第19卷第6期Chin J Aesth Plast Surg , Dec 2008 Vol. 19 No. 6
[12] WORSEG A , KUZBARI R , TAIRY CH G, et al. Long term re2sults of inflatable mammary implants [J ] . Br J Plast Surg , 1995
[13]徐青丽,陈红岚,郑雪芬.红外线照射预防外周中心静脉置管术后无菌性静脉炎的研究Chin J Nosocomiol Vol.18.No.1.2008.
[1 ] Malata CM, Feldberg L , Coleman DJ , etc. Textured or smooth implants for breastaugmentation ? Three year follow2up of aprospective randomized controlled trial [J ] . British Journal of Plastic Surgery , 1997 , 50 : 99 - 105. [2 ] Smahel J , Hurwitz PJ , Hurwitz N. SoftTissue response to textured silicone implantsin an animal experiment [J ] . Plast ReconstrSurg , 1993 , 92 (3) : 474.
[3] Barone FE , Perry L , Keller T, etc. Thebiomechanical and histopathologic effects ofsurface texturing with silicone and polyurethane in tissueimplantation and expan2sion [J ] . Plast Reconstr Surg , 1992 , 90 : 77. [4 ] Alain M. Danino , Philippe Basmacioglu , Seiko Saito , etc. Comparison of the Capsu2lar Response to the Biocell RTV and Mentor1600 Siltex Breast Implant Surface Texturing : A Scanning Electron Microscopic Study [J ] . Plastic and Reconstructive Surgery , 2001 , 108 (7) : 2047 - 52.
[5]张波,杨川,余力1隆乳术乳房假体容积的测算[J ] .实用美容整形外科杂志, 1998 , 9 (6) : 288 - 901
[6]张恒术,沈为民,薛斌,等1隆乳术前后体表测量参数的比较[J ] . 1999 , 24 (2) : 159 - 611 [7 ] SPEAR S L. Breast augmentation with reduced - height anatomic im2plants : the pros and cons[J ] , Clin Plast Surg , 2001 ,28 (3) :561 - 565. [ 8 ]宋儒耀,方彰林1美容整形外科学[M] .北京出版社11992年8月第2版. [ 9 ]赵耀中,林子豪,陈敏亮1经乳晕切口不损伤乳腺腺体的隆乳术[J ] .实用美容整形外科杂志, 1996 , 7 (6) : 300 -21
[10]陆文鹏,施耀明1改良的适应松垂小乳症的隆乳术[J ] .实用美容整形外科杂志, 1996 , 7 (5) : 247 - 91
[11]吴自萍,傅敏刚,叶琳,等1改进剥离范围在提高隆乳外形美中的应用[J ] .中华整形烧伤外科杂志, 1998 , 14 (2) : 124 - 61
[12]崔海燕,陈锦安肿胀麻醉下腋窝切口偏心圆隆乳术
[13] Asplund O. Capsular contracture in siliconegel and saline2filled breast implantsafter re2construction [ J ] . Plast Reconstr Surg , 1984 , 73 : 270 - 5.
[14] Gylbert L , Asplund O , Jurell G. Capsularcontracture after breast reconstruction withsilicone2gel and saline2filled implants : a 62ywar follow2up [ J ] . Plast Reconstr Surg , 1990 , 85 : 373 - 7.
[15] CHANG D W. Textured surface breast implants in the preventionof capsular contracture among breast augmentation patients : A meta- mnalysis of randomized controlled trials [J ] . Breast Diseases : AYear Book Quarterly , 2007 ,18 (1) :102 - 102.
[16] MA S L , GAO W C. Capsular contracture in breast augmentationwith textured versus smooth mammary implants : a systematic re2view[J ] . Zhonghua Zheng Xing Wai Ke Za Zhi , 2008 ,24 (1) :71 -74.
[17] WORSEG A , KUZBARI R , TAIRYCH G, et al. Long term re2sults of inflatable mammary implants [J ] . Br J Plast Surg , 1995 , 48 :18.
[18]马显杰,鲁开化,艾玉峰.乳晕切口胸大肌后间隙隆乳纤维包膜挛缩的成因及防治[ J ] .实用美容整形外科杂志, 1999 , 10 (5) :225 - 226.
[19]张东波.隆乳术后包膜挛缩外伤致血肿机化一例[J ] .中国美容医学, 2008 ,17 (1) :125 - 125. [20 ]袁伟伟,罗锦辉.隆乳术后纤维包膜挛缩机理的实验研究[J ] .第一军医大学学报, 1999 ,19 (1) :46 - 48. [3 ]
[21] PAJ KOS A , DEVA A K, VICKERY K, et al. Detection of sub2clinical infection in significant breast implant capsules [ J ] . PlastReconstr Surg , 2003 ,111 (5) :1605 - 1611
[22] Brinton , Louise A , Lubin , Jay H , CayBurich , Mary , etc. Mortality among Aug2mentation Mammoplasty Patients [J ] . Epi2 demiology , 2001 , 12 (3) : 321- 6.
[23] Mclaughlin JF , Nyren O , Blot WJ , etc. Cancer risk among women with cosmeticbreast : a population2based cohort study inSweden [ J ] . J Natl Cancer Inst , 1998 , 90 : 156 - 8.