非哺乳期乳腺炎术后即刻假体植入乳房再造术的临床应用

摘要

Objective:To explore the clinical application value of immediate breast reconstruction with implants after nipple-areola complex-sparing subcutaneous mastectomy for nonpuerperal mastitis .Methods:This study observed 22 women with nonpuerperal mastitis undergoing immediate breast reconstruction with implants after nipple-areola complex-sparing subcutaneous mastectomy from June 2012 to September 2014 .The perioperative results and follow-up records were analyzed . Results:The operation time was 104-132 min (mean 118 min) ,blood loss was 87-119 mL (mean 94 mL ) ,and the time of drainage tube removal was 10-21 d after operation .The length of hospitalization was 10-14 d (mean 12 d) ,and the average expenditure was about 20 000 RMB .There was no wound subcutaneous effusion ,no skin flap necrosis and no ischemia or necrosis in nipple-areola complex .In the evaluation of postoperative breast appearance ,9 cases were excellent ,13 cases were good ,and the excellent and good rate was 100% .All patients were followed up for 4-36 months (median 23 months) after operation .During the follow-up period ,no local recurrence ,breast deformation or fiber cystis contracture were formed .No upper extremity edema or dysfunction were found .Conclusions:Immediate breast reconstruction with implants after nipple-areola complex-sparing subcutaneous mastectomy possesses the advantage of minimal invasion , safety , quick postoperative recovery and simple operation for patients with nonpuerperal mastitis and the appearance of reconstructed breast is optimal .%目的：探讨非哺乳期乳腺炎术后即刻假体植入乳房再造的临床应用价值。方法：我院2012年6月至2014年12月收治的22例非哺乳期乳腺炎患者行保留乳头乳晕皮下腺体切除术后，同期于胸大肌后植入Mentor假体，即时再造乳房，对围手术期及术后随访结果进行分析。结果：22例患者手术时间为104～132 min（平均118 min），术中出血量为87～119 mL（平均94 mL ），术后引流管拔除时间为10～21 d。住院天数10～14 d（平均12 d），住院平均费用2万元人民币。术后所有患者均无积液、皮瓣坏死，无乳头乳晕缺血坏死。术后乳房外观评价中，9例为优，13例为良，优良率为100％。术后随访时间4～36个月（中位随访时间23个月）。随访期间无病灶复发、乳房变形及假体纤维包裹囊形成，患侧上肢无水肿及功能障碍。结论：保留乳头乳晕的非哺乳期乳腺炎术后运用假体植入法行即刻乳房再造，创伤小、安全、快速，恢复期短，手术操作简单易行，效果满意。