保留乳头乳晕的乳腺癌改良根治术后同期应用TRAM乳房再造的护理

目的探讨保留乳头乳晕的乳腺癌改良根治术后，同期应用下腹部横形腹直肌肌皮瓣（TRAM）进行乳房再造手术的护理。方法加强术前心理护理；供区、受区皮肤准备、术后密切观察肌皮瓣的血运；防止乳头乳晕受压；保持有效的负压引流；加强功能锻炼及有效控制感染。结果自2000年10月～2005年1月，10例保留乳头乳晕的乳腺癌改良根治术后，同期应用TRAM乳房再造的患者手术均获成功，无并发症，再造乳房形态良好。结论加强围手术期的护理是确保乳房再造肌皮瓣存活的关键。

Nursing on TRAM for Breast Reconstruction after Modified Radical Mastectomy with Reserving Nipple

Objective To explore the nursing of transverse rectus abdominis myocutaneous flap(TRAM) for breast reconstruction after modified radical mastectomy with reserving nipple. Methods Before the operation, patient's mental care was enhanced and their skin preparation for both supplying and applied section was well done. After the operation, blood circulation of TRAM was observed carefully, and the methods of preventing oppression of the nipple and keeping effective drainage and functioned training as well as control infection were taken carefully. Results From October 2000 to Jannary 2005, 10 cases of TRAM after modified radical mastectomy with reserving nipple were successful and no complication occurred and morphology of reconstructed breasts was good. Conclusions Enhancing perioperation nursing is the key of successful TRAM.