【摘要】：目的探討傳統(tǒng)下蒂法巨乳縮小術(shù)成形術(shù)存在的弊端,對不足之處加以改進,形成一種具有良好乳頭乳暈感覺功能、良好的血運及持久保持豐滿自然的乳房外形的巨乳縮小術(shù)式,并通過隨訪研究評價手術(shù)效果。方法通過對2004年7月至2014年12月應(yīng)用下蒂法巨乳縮小成形術(shù)的臨床病歷資料進行回顧性分析,總結(jié)應(yīng)用該技術(shù)的臨床經(jīng)驗,針對術(shù)后效果不佳的原因采取相應(yīng)預(yù)防措施,應(yīng)用下蒂法聯(lián)合真皮帽技術(shù)行巨乳縮小整形。并分別采取術(shù)前術(shù)后客觀數(shù)據(jù)測量、問卷調(diào)查及評分量表對兩種術(shù)式術(shù)后效果進行評價。結(jié)果2004-2014年對15例乳房肥大(伴乳房下垂)患者行巨乳縮小術(shù),其中A組運用傳統(tǒng)下蒂法9例,B組運用下蒂法聯(lián)合真皮帽技術(shù)6例。結(jié)果：(1)所有乳房肥大患者癥狀體征得到了明顯的緩解；(2)術(shù)后乳房形態(tài)豐滿自然,基本對稱；(3)乳頭、乳暈血供、感覺良好,未發(fā)生乳頭乳暈壞死；其中A組1例術(shù)后乳頭感覺功能輕度減退,3個月后逐漸恢復(fù)；瘢痕增生1例(后期抗瘢痕治療效果改善)；2例(2側(cè))發(fā)生血腫,切開引流后傷口愈合。(4)A組2例患者術(shù)后1.5-2年出現(xiàn)乳房下極過度飽滿、乳房下垂等并發(fā)癥；B組無乳房下極過度飽滿、乳房下垂等并發(fā)癥,術(shù)后遠期美學(xué)效果較理想,患者對乳房形態(tài)滿意。(5)經(jīng)抗瘢痕治療半年,術(shù)后倒“T”瘢痕不甚明顯。結(jié)論下蒂瓣法聯(lián)合真皮懸吊乳房縮小術(shù)式為下蒂組織瓣起到了一個很好的支撐作用,克服了單純下蒂法乳房易下垂等并發(fā)癥的發(fā)生,更利于塑形出具有良好突度并且形態(tài)豐滿的乳房。該法重建乳房血供可靠、重建乳房后感覺功能恢復(fù)良好,遠期觀察效果更為持久,是矯治乳房肥大的有效方法。
[Abstract]:Objective to investigate the disadvantages of traditional mammoplasty of mammoplasty, to improve the defects, and to form a new method of mammoplasty with good nipple areola sensation, good blood supply, and keeping a full and natural mammary shape for a long time. The effect of operation was evaluated by follow-up study. Methods through the retrospective analysis of the clinical records of the minimization of mammoplasty with tipping from July 2004 to December 2014, the clinical experience of this technique was summarized, and the corresponding preventive measures were taken in view of the causes of the poor postoperative effect. The technique of lower tipping combined with dermis cap was used to reduce and shape the large milk. Objective data before and after operation, questionnaire and scoring scale were used to evaluate the effect of the two methods. Results from 2004 to 2014, 15 cases of mammary hypertrophy (accompanied with prolapse) were treated with mammoplasty, of which 6 cases in group A were treated with traditional lower tipping method and 6 cases in group B were treated with lower tipping method combined with dermis cap technique. Results: (1) the symptoms and signs of all patients with breast hypertrophy were obviously relieved; (2) the breast shape was abundant and natural after operation, and the basic symmetry; (3) nipple, areola blood supply, feeling good, no nipple areola necrosis; In group A, the papillary sensory function decreased slightly after operation and gradually recovered after 3 months, and hematoma occurred in 2 cases (2 sides) with hypertrophic scar in 1 case (improved anti-scar effect in later stage), and in 2 cases (2 sides) in group A. After incision and drainage, the wound healed. (4) in group A, 2 cases had extremely overfull breast, and complications such as prolapse of breast occurred 1.5-2 years after operation. In group B, there were no complications such as extremely overfullness of breast and prolapse of breast, and the long-term aesthetic effect was better than that in group B. The patients were satisfied with the breast shape. (5) after half a year of anti-scar treatment, the "T" scar was not obvious after operation. Conclusion the method of lower pedicle flap combined with dermis suspending mammary shedding can support the lower pedicle tissue flap and overcome the complications such as easy prolapse of the lower pedicle breast. More conducive to shaping the shape of the breast with good protuberance and full shape. This method is an effective method for the treatment of breast hypertrophy.
【學(xué)位授予單位】：安徽醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2015
【分類號】：R655.8

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