CAJ | 학술논문

目的评价多层螺旋CT(multidetector-row computed tomography,MDCT)血管造影对腹部穿支皮瓣乳房再造术前血管评估的意义.方法 2006年12月至2009年6月,利用MDCT血管造影对34例乳房再造患者行术前腹部穿支血管探测,根据探测结果拟定乳房再造的手术方式,并作术中实际情况和术前探测的对比.选取该时间段之前未行螺旋CT血管造影的22例腹部游离皮瓣乳房再造的病例设立对照组,比较两组间手术方式改变率,手术时间差异,以及术后皮瓣坏死的发生率.结果实验组术前手术方式改变率为23.53%,对照组为0(P=0.00),实验组术中手术方式改变率为0,对照组为13.64%(P=0.00);实验组切取皮瓣的平均手术时间为(2.51±0.64)h,对照组为(4.42±0.21)h(P＜0.05).实验组皮瓣并发症发率为6.12%,对照组为12.5%(P=0.017).结论 MDCT是一种准确、简便的方法,有助于更合理地制定乳房再造的手术方式,节约手术时间,降低手术风险.
목적 평개다층라선CT(multidetector-row computed tomography,MDCT)혈관조영대복부천지피판유방재조술전혈관평고적의의.방법 2006년12월지2009년6월,이용MDCT혈관조영대34례유방재조환자행술전복부천지혈관탐측,근거탐측결과의정유방재조적수술방식,병작술중실제정황화술전탐측적대비.선취해시간단지전미행라선CT혈관조영적22례복부유리피판유방재조적병례설립대조조,비교량조간수술방식개변솔,수술시간차이,이급술후피판배사적발생솔.결과 실험조술전수술방식개변솔위23.53%,대조조위0(P=0.00),실험조술중수술방식개변솔위0,대조조위13.64%(P=0.00);실험조절취피판적평균수술시간위(2.51±0.64)h,대조조위(4.42±0.21)h(P＜0.05).실험조피판병발증발솔위6.12%,대조조위12.5%(P=0.017).결론 MDCT시일충준학、간편적방법,유조우경합리지제정유방재조적수술방식,절약수술시간,강저수술풍험.
Objective To investigate the significance of preoperative MDCT angiography for breast reconstruction with abdominal flap. Methods Preoperative MDCT angiography scans were performed on 34 patients who underwent breast reconstruction with abdominal flaps during December 2006 to June 2009. The operation was designed based on the MDCT results. Then the MDCT results were proved intraoperatively. Another 22 cases who underwent breast reconstruction with abdominal flap without preoperative MDCT were selected as controls. The rate of operative method change, the operation time and the flap necrosis were compared between the two groups. Results The preoperative design changed in 23.53% of the patients, based on the MDCT results. No one had any method change intraoperatively in the group with MDCT. The operative method was changed intraoperatively in 13.64% of the patients in the control group. The mean time spending on flap harvesting was (2.51 ± 0. 64)h in the experimental group and (4.42 ±0. 21)h in the controlled group(P ＜ 0. 05). The rate of complication was 6. 12% in the experimental group and 12. 5% in the control group (P = 0. 017). Conclusions Preoperative MDCT angiography is an easy and reliable method for breast reconstruction with abdominal flap. The preoperative design can be more reasonable. It helps to save the operation time and reduce the risk.