论文部分内容阅读
目的比较“保留乳房的乳腺癌根治术”(A组)和“保留乳头、皮肤乳腺癌根治术联合即时假体置入隆乳术”(B组)两种术式对保留乳房外形等方面的效果。方法A组39例,B组12例。术后从乳头外观、双乳头水平差距、双乳头距同侧腋前线垂直距离之差距和疤痕对乳房外形影响等四个方面量化,评估所保留乳房的外形美观效果。四项积分≥21分为优,13~20分为良,<13分为差。结果①A组优良率为82.1%,B组为100.0%。②影响保留乳房外形的常见问题包括因切口疤痕致乳房变形、乳头歪斜、坏死、不自然挺立,以及与对侧乳头水平高度差距明显。结论①B组术式是具有保留乳房条件和有经济基础患者的首选术式。②术前认真设计手术切口,术中注意保留乳腺组织的彻底游离与切除、缝合技巧以及假体体积计算、术后包扎注意避免压迫乳头等,将使保留乳房具有良好外形。
Objective To compare the two methods of “preservation of breast cancer with radical mastectomy” (group A) and “preservation of nipple and skin breast cancer combined with immediate prosthesis implantation with breast augmentation” (group B) in terms of preserving breast shape, etc. effect. Methods 39 cases in group A and 12 cases in group B. Postoperatively, the appearance of the nipple, the level difference between the two nipples, the distance between the double nipples and the vertical distance from the same side of the anterior iliac crest, and the effect of the scar on the shape of the breast were quantified to evaluate the aesthetic appearance of the retained breast. Four integrals ≥ 21 are excellent, 13 to 20 are good, and <13 is poor. Results The excellent and good rate in group 1A was 82.1%, and that in group B was 100.0%. 2 Common problems affecting the retention of breast shape include deformed breast due to incision scars, skewed nipples, necrosis, unnatural erection, and significant differences in horizontal height from the contralateral nipple. Conclusion Group 1B operation is the preferred surgical method for patients with preserved breast condition and economic basis. 2 carefully design surgical incision preoperatively, intraoperative attention to retain the complete removal of the breast tissue and resection, suture techniques and prosthesis volume calculation, postoperative dressing to avoid compression of the nipple, etc., will keep the breast with a good shape.