本文關(guān)鍵詞： 乳腺切除術(shù) 背闊肌皮瓣移植 I期乳房再造 創(chuàng)面修復(fù) 術(shù)后美容 術(shù)后并發(fā)癥　出處：《廣西醫(yī)科大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：目的:探討背闊肌皮瓣在多種乳房切除術(shù)后乳房再造或晚期乳腺癌切除術(shù)后創(chuàng)面修復(fù)術(shù)方面的臨床應(yīng)用效果。方法:回顧性分析2012年12月至2016年12月間我院接受乳房切除術(shù)后背闊肌肌皮瓣移植術(shù)患者的臨床病理資料,隨訪術(shù)后并發(fā)癥,均術(shù)后3月隨訪美容效果。采用Harris美容評(píng)價(jià)標(biāo)準(zhǔn),采用SPSS 21.0軟件做統(tǒng)計(jì)分析。分析乳腺腫瘤部位,大小,淋巴結(jié)清掃術(shù),切取皮瓣大小、乳腺手術(shù)方式對(duì)術(shù)后美容效果及術(shù)后并發(fā)癥率的影響,并做Χ2檢驗(yàn)分析。結(jié)果:總計(jì)42例手術(shù),Ⅰ期乳房重建30例,單純創(chuàng)面修復(fù)術(shù)12例,術(shù)后患者總體美容滿意度較高,優(yōu)秀率達(dá)80.56%,良好率達(dá)29.44%,無(wú)差評(píng)。數(shù)據(jù)分析美容效果與腫瘤位置、大小、是否做淋巴結(jié)清掃術(shù)、乳腺切除術(shù)的術(shù)式對(duì)術(shù)后美容效果評(píng)價(jià)均無(wú)顯著差異性(P0.05)。無(wú)術(shù)后遠(yuǎn)期嚴(yán)重并發(fā)癥,術(shù)后近期并發(fā)癥有背部血清腫,9例(21.4%),切口愈合延遲例3例(7.5%)。這些與切取皮瓣大小有顯著相關(guān)性(P0.05)�；紓�(cè)上肢異常感覺(jué)與行腋窩淋巴結(jié)清掃術(shù)有顯著相關(guān)性(P0.05)。結(jié)論帶蒂背闊肌皮瓣移植術(shù)既能為乳腺癌保乳整形術(shù),保守性乳腺切除術(shù)后乳腺重建提供自體組織來(lái)源,也能為改良根治術(shù)或根治術(shù)后胸壁創(chuàng)面修復(fù)提供技術(shù)支持和保障,在乳腺癌手術(shù)治療方面的臨床適應(yīng)性廣。應(yīng)用于保乳或重建乳房的美容效果好,術(shù)后遠(yuǎn)期滿意度高。對(duì)乳腺腫瘤灶大,切除后胸壁缺損大,切口縫合困難的患者能提供及時(shí)創(chuàng)面修復(fù),且手術(shù)成功率高,嚴(yán)重術(shù)后并發(fā)癥率不高,能為各種乳房切除術(shù)的成功提供技術(shù)保障,臨床實(shí)用價(jià)值高。
[Abstract]:Objective: to investigate the clinical application of latissimus dorsi flap in reconstruction of breast after multiple mastectomy or wound repair after resection of advanced breast cancer. The clinicopathological data of patients with latissimus dorsi myocutaneous flap after mastectomy from December 2012 to December 2016 were retrospectively analyzed. The postoperative complications were followed up on March. Harris beauty evaluation standard and SPSS 21.0 software were used to analyze the location and size of breast tumor. The effect of lymph node dissection, flap size and mammary gland operation on postoperative cosmetic effect and postoperative complication rate were analyzed. Results: 42 cases were operated on, 30 cases were stage 鈪，

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