目的:从乳腺癌术后乳房区神经感觉恢复角度探讨乳房重建的手术时机.方法:将2005年6月-2009年12月19例乳腺癌术后行乳房重建患者的20侧乳腺分为即刻乳房重建组和延期乳房重建组,并分别对两组患者的重建乳腺分为9个区,再对9个区的神经感觉分别进行测试、测量以及调查对手术的满意度.结果:随访2年,两组患者重建乳房区神经感觉均有明显恢复,各象限的感觉恢复情况两组有统计学差异;两组患者对重建乳房的外形、双侧乳房的对称性及对皮肤感觉的满意度无明显差异;两组患者中,0区的皮肤感觉恢复明显较F区的恢复早、且好;两组患者在恢复过程中出现了明显不同的分区现象.结论:在神经感觉方面,即刻乳房重建组较延期重建组有恢复早、恢复好的优势;在神经感觉恢复过程中出现的分区现象是神经恢复的自然过程,对于了解神经恢复的阶段及程度有指导意义,对临床选择乳房重建的时机提供理论依据,具有一定的临床实用价值.%Objective To discussion of breast reconstructive surgery opportunity from the angle of sensation recovery of breast area after mastectomy. Methods A total from June 2005 to December 2009 over the same period 19 cases of breast reconstruction after breast cancer patients, a total of 20 side of the breast,is divided into immediate breast reconstruction group and delayed breast reconstruction group,and the two groups of patients respectively of mammary gland is divided into nine area reconstruction,then the nerve again to 9 area is measured and the satisfaction of surgery is investigated. Results Follow-up 2 years,two groups of patients with breast reconstruction had significant sensory recovery.ln each quadrant,the two groups were significantly different sensory recovery.Degree of satisfaction in the two group about the shape of reconstructive breast,symmetry of bilateral breast and neural sensory,which is no obvious differences.ln the two group, Cutaneous sersory recovery in the "O" area is earlier and better than in the "P area. Two groups of patients during the recovery process appears markedly different partition phenomenon. Conclusions In neural feeling, immediate group have restored earlier and better advantage than delayed group;ln the course of neurological recovery partition phenomenon is a natural process, has significance for understanding the stages of nerve recovery and degree, provides theoretical basis on breast reconstructive surgery opportunity,has certain clinical practical value.
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