陈军

[摘要]目的 探讨胸外侧筋膜皮瓣移植在乳腺癌保乳术乳房修复中的应用效果。方法 选取2015年7月～2017年7月我院收治的80例乳腺癌患者作为研究对象。根据乳腺修复方式将患者分为两组，每组各40例。对照组患者采用背阔肌肌皮瓣移植，观察组患者采用胸外侧筋膜皮瓣移植。观察比较两组患者的手术一般情况（手术时间、术中出血量）、乳腺外观及乳房外形的情况。结果 观察组患者的手术时间短于对照组，术中出血量少于对照组，差异有统计学意义（P<0.05）。两组患者治疗前后的乳头到中线距离、乳头到胸骨上窝距离比较，差异无统计学意义（P>0.05），且两组治疗后的各指标比较，差异无统计学意义（P>0.05）。观察组患者治疗后的乳房外观优良率与对照组比较，差异无统计学意义（P>0.05）。结论 胸外侧筋膜皮瓣移植在乳腺癌保乳术乳房修复中，可明显缩短手术时间，手术美容效果好。

[关键词]胸外侧筋膜皮瓣；乳腺癌；保乳术；乳房修复

[中图分类号] R737.9 [文献标识码] A [文章编号] 1674-4721（2018）11（b）-0066-03

[Abstract] Objective To investigate the application effect of thoracic lateral fascial flap transplantation in breast repair of breast conserving surgery. Methods A total of 80 patients with breast cancer who were admitted to our hospital from July 2015 to July 2017 were selected as subjects. Patients were divided into two groups according to the method of breast repair， with 40 cases in each group. The control group was given latissimus dorsi muscle flap transplantation. The observation group was given thoracic lateral fascial flap transplantation. The general conditions of surgery （surgery time， intraoperative blood loss）， breast appearance and breast shape were observed and compared between the two groups. Results The operation time in the observation group was shorter than that in the control group， and the intraoperative blood loss was less than that in the control group， the difference was statistically significant （P<0.05）. There was no statistically significant difference in the distance from the nipple to the midline and the distance from the nipple to the sternal fossa before and after treatment in both groups （P>0.05）. There was no statistically significant difference in all indices between the two groups after treatment （P>0.05）. There was no statistically significant difference in the excellent breasts appearance rate between the observation group and the control group after treatment （P>0.05）. Conclusion The thoracic lateral fascial flap transplantation can significantly shorten the operation time and has a favorable cosmetic effect in the breast repair conserving surgery of breast cancer.

[Key words] Thoracic lateral fascial flap； Breast cancer； Breast conserving surgery； Breast repair

乳腺由纖维组织、皮肤、脂肪及腺体构成，乳腺癌多发于乳腺上皮组织，是女性的高发疾病，且趋于年轻化，严重威胁了女性的身心健康和生活质量。保乳术是当前早期乳腺癌的一种重要治疗方法[1]。但是在乳腺癌保乳术中有1/3的患者治疗后存在乳腺外观畸形，美容效果差。如何在保证乳腺癌治疗效果的前提下，同时保证患者的手术美观，是当前研究的热点，也是如今乳腺外科医生的一个新挑战[2]。近年来，有医学人士提出，肿瘤整形手术应用到乳腺癌保乳术中，取得了较好的美容效果，且安全性好。对于……