前锯肌肌瓣联合假体植入在中青年乳腺癌患者保留乳头乳晕根治术后乳房再造的效果

目的探讨前锯肌肌瓣联合假体植入在中青年乳腺癌患者保留乳房乳晕根治术后乳房再造的效果。 方法选取2015年1月至2017年2月进行诊治的乳房癌患者64例进行前瞻性研究，随机分为改良组(32例)和传统组(32例)，改良组患者给予前锯肌肌瓣联合假体植入的保留乳头乳晕的乳腺癌改良根治术，传统组患者给予传统的乳腺癌改良根治术。采用SPSS 19.0统计学软件进行统计分析，术中相关指标及FACT－B评分以( ±s)表示，组间比较采用独立t检验；术后并发症采用χ²检验，以P<0.05表示差异具有统计学意义。 结果与传统组相比，改良组患者的术中出血量、手术时间均显著增加(P<0.05)，而淋巴结清扫数目相比，差异无统计学意义(P>0.05)；术前，两组患者FACT－B各分项及总分差异均无统计学意义(P>0.05)；术后，与传统组相比，改良组的健康状况、情感状况、社会/家庭状况、附加关注及FACT－B总分均显著升高，差异具有统计学意义(P<0.05)；改良组患者术后并发症的总发生率为9.4%，传统组为15.6%，差异无统计学意义(P>0.05)。 结论前锯肌肌瓣联合假体植入应用于保留乳头乳晕的中青年乳腺癌患者根治术后乳房再造的临床效果较好，可显著提高患者的生活质量，且安全性较高。

Effect of the breast reconstruction of nipple areola sparing modified radical mastectomy by serratus anterior muscle flap combined with prosthesis implantation in young and middle-aged breast cancer patients

ObjectiveTo investigate the effect of the breast reconstruction of nipple areola sparing modified radical mastectomy by serratus anterior muscle flap combined with prosthesis implantation in young and middle-aged breast cancer patients. Methods64 cases of breast cancer were collected from January 2015 to February 2017 in our hospital, according to the different operation ways, they were divided into improved group (32 cases) and traditional group (32 cases), the improved group was given the modified radical mastectomy with nipple areola sparing by serratus anterior muscle flap combined with prosthesis implantation, the traditional group was given traditional modified radical mastectomy. Statistical analysis were performed by using SPSS 19.0 software, preoperative related indicators and the total score of FACT-B were presented as and examined by using t test; postoperative complications were examined by chi square test, a P<0.05 was considered as significant difference. ResultsCompared with the traditional group, the intraoperative blood loss, operation time of the improved group were both significantly increased (P<0.05), but there was no significant difference in the number of lymph node dissection between the two groups (P>0.05); Before operation, there were no significant difference in the each component and total score of the FACT-B between the two groups (P>0.05); After operation, compared with the traditional group, the physical condition, emotional state, social/family situation, additional attention and the total score of FACT-B were significantly increased of the improved group, the difference was statistically significant (P<0.05). The total incidence of postoperative complications was 9.4% in the improved group and 15.6% in the traditional group, the difference was not statistically significant (P>0.05). ConclusionBreast reconstruction of nipple areola sparing modified radical mastectomy by serratus anterior muscle flap combined with prosthesis implantation in young and middle-aged breast cancer patients has good clinical effect and good safety, can significantly improve the quality of life.