单纯型和复杂型巨乳症的诊断及治疗

目的：探讨单纯型和复杂型巨乳症的临床特点，诊断要点及治疗方法，方法：回顾性分析1990－2000年民治21例巨乳症（37个乳房），包括单纯型巨乳症16例29个乳房，复杂型巨乳症（巨乳症合并纤维腺瘤病等广范围病变者）5例8个乳房的临床，病理资料，结果：患者平均年龄23岁，21例均行手术治疗，16例单纯巨乳症者施以常规缩乳术，5例复杂型巨乳症中，2例为双乳腺纤维腺瘤病合并巨大型巨乳症，采用皮下腺体切除一期乳房成形术，2例几乎占据全乳的单乳巨纤维腺瘤并巨乳症，1例行皮下肿瘤切除，1例行肿瘤切除乳房成形术；1例双乳腺腺有块样物形成者行选择性腺体大部分切除乳房成形术。经随访至今患者乳房外形满意无肿瘤复发，结论：巨乳症好发于青春发育少女和青年妇女，诊断时应注意区别单纯型巨乳症和复杂型巨也症，术前B超，术中仔细探查及快速病检是必要的，单纯巨乳症常规缩乳术即可，复杂型巨乳症则应区别对待，彻底切除病变，一期乳房成形获得满意疗效，乳腺纤维腺瘤病合并巨乳症者，可采用皮下乳腺切除，真皮及皮下组织蒂一期乳房成形术。

Diagnosis and treatment of simple macromastia and complex macromastia

Objective To study the clinica features, diagnosis and surgical treatment of simple and complex macromastia. Methods The clinical and pathological data of 21 patients with macromastia in our hospital from 1990 to 2000 were analysed retrospectively. Simple macromastia in 16 patients with 29 breasts, complex macromastia in 5 patients with 8 breasts. Results The average age of patients was 23 years old. All the 21 patients were treated surgically. Among the 5 patients with complex macromastia, subcutaneous mastectomy and reconstruction were performed on 2 patients with breast fibroadenomatosis; of the 2 patients with giant fibroadenoma, one underwent tumor excision, the others were subjected to tumor excision with reduction mammaplasty; the last one with breast fibrous disease, selective partial breast excision and reduction mammaplasty was performed. All the patients had satisfactory mammary appearance and hadn't recurrrence of the breast disease in follow up period. Conclusions (1) Macromastia often happens in the adolescent and young women. (2) It is necessary to do biopsy during operation for distinguishing the simple from the complex macromastia. (3) The treatment for simple macromatia is reduction mammaplasty; for complex macromatia is dissection of the disease area completely and redution mammaplasty simultaneously. For macromastia with fibroadenomatosis, subcutaneous mastectomy with reconstruction can prevent tumor recurrence and get better mammary appearance.