CAJ | 학술논문

【目的】探讨应用游离皮瓣对乳腺癌手术患者进行乳房重建的应用方法及疗效。【方法】收集本科2008年1月至2011年1月间住院的40例乳腺癌手术患者，随机分为研究组和对照组，研究组应用腹壁下动脉穿支游离皮瓣进行乳房重建，对照组给予转移下腹部横行腹直肌肌皮瓣进行乳房重建，对比两组手术的疗效。【结果】研究组重建的乳房未见明显萎缩，质地柔软，色泽外形接近正常乳房，腹部供区恢复良好未见腹壁薄弱的现象发生。研究组手术时间为（6．1±0．7）h，术后住院时间平均为（7．2±1．1）d与对照组（5．9±1．9，14．7±2．3）比较无显著差异（ P＞0．05），未见术后腹部供区的皮下积血等腹部并发症的发生，与对照组比较具有显著差异（ P ＜0．05）。【结论】应用腹壁下动脉穿支游离皮瓣进行乳房重建效果确切，减少了腹部并发症发生的机率同时不影响肿瘤的治疗，达到患者对于胸部塑形的要求，值得在临床上推广应用。
【목적】탐토응용유리피판대유선암수술환자진행유방중건적응용방법급료효。【방법】수집본과2008년1월지2011년1월간주원적40례유선암수술환자，수궤분위연구조화대조조，연구조응용복벽하동맥천지유리피판진행유방중건，대조조급여전이하복부횡행복직기기피판진행유방중건，대비량조수술적료효。【결과】연구조중건적유방미견명현위축，질지유연，색택외형접근정상유방，복부공구회복량호미견복벽박약적현상발생。연구조수술시간위（6．1±0．7）h，술후주원시간평균위（7．2±1．1）d여대조조（5．9±1．9，14．7±2．3）비교무현저차이（ P＞0．05），미견술후복부공구적피하적혈등복부병발증적발생，여대조조비교구유현저차이（ P ＜0．05）。【결론】응용복벽하동맥천지유리피판진행유방중건효과학절，감소료복부병발증발생적궤솔동시불영향종류적치료，체도환자대우흉부소형적요구，치득재림상상추엄응용。
[Objective] To explore the application methods and efficacy of free flap in breast reconstruction for patients undergoing breast cancer operation .[Methods]A total of 40 inpatients undergoing breast cancer operation in our department from Jan .2009 to Jan .2011 were randomly divided into study group and control group .The study group underwent breast reconstruction by using inferior epigastric perforating artery free flap ,while the control group underwent breast reconstruction by using transferred lower abdominal transverse rectus abdominis myocutaneous flap .The efficacy was compared between two groups .[Results]The recon-structed breasts in the study group showed no obvious atrophy ,and had soft texture ,and the color and shape were close to normal breasts .Abdominal donor sites recovered well ,and no abdominal weak phenomenon oc-curred .The operation time of the study group was 6 .1 ± 0 .7h ,and postoperative average hospitalization time was 7 .2 ± 1 .1d ,and there was no significant difference between the study group and control group ( P >0 .05) .No postoperative abdominal complications such as subcutaneous hematocele in abdominal donor sites occurred in the study group ,and there was significant difference between the study group and control group ( P<0 .05) .[Conclusion] The inferior epigastric perforating artery free flap for breast reconstruction has certain efficacy ,and can reduce the probability of abdominal complications and not affect the treatment of the tumors , and achieve the requirement for chest shaping .Therefore it is worthy of clinical promotion .