改良剖开加Z形瓣成形法矫正Ⅲ级乳头内陷

目的 介绍一种矫正Ⅲ级乳头内陷的方法改良剖开加z形瓣成形法。方法2002年1月～2005年3月对28～38岁先天性Ⅲ级乳头内陷已育女性患者手术16例31侧乳头。手术通过乳头中点水平对称剖开乳头，直视下彻底松解乳头下挛缩纤维束及乳腺管，再翻转乳头下组织瓣填补因纤维束及乳腺管被打断后的间隙，然后于乳头两侧与乳晕交界处分别作Z字成形。结果术后乳头挺拔，无1例出现乳头坏死、感染，切口均Ⅰ期愈合。随访6个月～3年，乳头感觉无明显减退，无勃起功能障碍，切口局部无明显瘢痕。除1侧乳头术后6个月再次轻度内陷外，余均无复发。结论改良剖开加Z形瓣成形法是一种矫正乳头内陷的有效方法，适用于重度无哺乳要求的女性患者。

A KIND OF IMPROVED OPERATIVE CORRECTION OF SEVERE INVERTED NIPPLES

Objective To introduce a kind of improved operative method for correction of severe inverted nipples. Methods Sixteen patients (aged 28-38 years) with 31 inborn inverted nipples were operated with the improved method from January 2002 to March 2005. The nipple was incised horizontally through the middle, the fibrotic band was released, and the tissue below the nipple was contracted. Then the defective space with mammary gland flap. Finally, a Z-shaped suture was employed at each base of nipple. Results The shapes of these nipples were satisfactory. No infection and necrosis of the nipples occurred. The follow-up showed that the results were perfect in the sensory and ejective functions of nipples. All the corrected nipples did not have recurrence except one nipple. The scars in the local site were limited and unconspicuous. Conclusion Severe inverted nipples can be corrected effectively by the combined improved incisions and Z-shaped sutures. This method is suitable for the female patients with no requirment for feeding.