CAJ | 학술논문

背景：女性Poland综合征患者同时伴有乳房发育不全甚至不发育，乳房缺失及乳房畸形等，可根据畸形程度实施背阔肌肌瓣转移、脱细胞真皮组织或乳房硅胶假体植入重塑乳房、改善胸部外形。 　　目的：探索乳房硅胶假体及脱细胞异体真皮在女性Poland综合征患者乳房缺如畸形再造中的应用，评价其早期临床效果。 　　方法：回顾性分析6例女性Poland综合征患者临床资料，其中单侧(双侧)乳房缺如、患侧(双侧)胸大肌发育不全、胸壁组织量较健侧略差4例，接受乳房硅胶假体植入治疗；单侧乳房缺如、患者胸大肌缺如、肋骨缺如、胸壁软组织菲薄且粘连2例，接受乳房硅胶假体及脱细胞真皮植入联合背阔肌肌瓣转移治疗。 　　结果与结论：6例植入后4 d时均有水肿，1例切口渗液，均甲级愈合。术后随访1-12个月，3例可触及假体轮廓，1例乳房为中等硬度，均无乳房结节及疼痛，切口瘢痕无增生，乳房外观均匀，无乳房起皱。证实乳房硅胶假体及脱细胞异体真皮辅助女性Poland综合征乳房畸形矫正，操作方便，可减少术中损伤，降低手术难度并减轻患者痛苦，在严格把握适应证的前提下可取得较好临床效果。
배경：녀성Poland종합정환자동시반유유방발육불전심지불발육，유방결실급유방기형등，가근거기형정도실시배활기기판전이、탈세포진피조직혹유방규효가체식입중소유방、개선흉부외형。 　　목적：탐색유방규효가체급탈세포이체진피재녀성Poland종합정환자유방결여기형재조중적응용，평개기조기림상효과。 　　방법：회고성분석6례녀성Poland종합정환자림상자료，기중단측(쌍측)유방결여、환측(쌍측)흉대기발육불전、흉벽조직량교건측략차4례，접수유방규효가체식입치료；단측유방결여、환자흉대기결여、륵골결여、흉벽연조직비박차점련2례，접수유방규효가체급탈세포진피식입연합배활기기판전이치료。 　　결과여결론：6례식입후4 d시균유수종，1례절구삼액，균갑급유합。술후수방1-12개월，3례가촉급가체륜곽，1례유방위중등경도，균무유방결절급동통，절구반흔무증생，유방외관균균，무유방기추。증실유방규효가체급탈세포이체진피보조녀성Poland종합정유방기형교정，조작방편，가감소술중손상，강저수술난도병감경환자통고，재엄격파악괄응증적전제하가취득교호림상효과。
BACKGROUND:Women with Poland syndrome are often accompanied by breast dysplasia and even agenesis, absence of breast and breast deformity. For such patients, we can implement different operations according to the degree of deformity, for remodeling the breast and improving chest shape. OBJECTIVE:To explore the clinical effects of breast reconstruction with silicone implants and acellular dermal matrix in Poland patients with breast deformity. METHODS:A retrospective analysis of six female cases of Poland syndrome was conducted, including four patients with unilateral (bilateral) breast agenesis, hypoplasia of the ipsilateral (bilateral) pectoralis major muscle, less tissue volume than the healthy side who were subjected to implantation of silicone breast prostheses, and two patients with unilateral breast agenesis, agenesis of the pectoralis major muscle and ribs, poor and adhered chest wal soft tissue who were subjected to implantation of silicone breast prosthesis and acellular dermal matrix combined with latissimus dorsi myocutaneous flap. RESULTS AND CONCLUSION:Six patients at day 4 after operation presented with edema, among whom, one appeared to have wound exudate. But al the six patients were healed. Then, the patients were fol owed up for 1-12 months. Outline of breast prosthesis could be touched in three cases, and one case presented with moderate hardness of the breast. However, there were no breast nodules and pain, no scar hyperplasia of the breast. Breast was uniform in appearance, with no wrinkle. These findings confirm that the silicone breast prosthesis with acellular dermal matrix is easy to operate, can reduce intraoperative injury, decrease the difficulty of the operation and al eviate the suffering of patients, which can obtain better clinical effects in the strict grasp of indications.