邻近扩张皮瓣在局部晚期乳腺癌手术中应用的临床研究

目的探讨邻近扩张皮瓣在局部晚期乳腺癌（LABC）手术中临床应用效果分析。方法选取我院从2006年1月～2013年12月收治的34例局部晚期乳腺癌手术患者作为研究对象。按照人院顺序分为治疗组与对照组，A组试验组16例，B组对照组18例。对照组即行乳腺癌根治术，同时予全厚皮或背阔肌皮瓣转移修补皮肤缺损，治疗组应用邻近扩张皮瓣配合乳腺癌根治术治疗。对比两组患者围手术期的各项临床数据、术后胸壁外观与感觉、局部复发情况。结果两组患者各项临床指标对比，试验组优于对照组，差异具统计学意义（P〈0．05）。试验组患者的术后胸壁外观与感觉显著优于对照组，差异具统计学意义（P〈0．05）。试验组患者的复发率低于对照组，差异具统计学意义（P〈0．05）。结论应用邻近扩张皮瓣在局部晚期乳腺癌手术中临床效果好，对局部晚期乳腺癌来说是一种安全、有效的治疗方法，值得临床推广应用。

Clinical study on the application of adjacent expanded flaps in the surgery of locally advanced breast cancer

Objective To explore the effects of clinical application of adjacent expanded flaps in the surgery of locally advanced breast cancer （LABC）. Methods 34 patients with LABC who were admitted to our hospital from January 2006 to December 2013 were selected as subjects. They were assigned to treatment group and control group based on admission order, with 16 patients in treatment group （group A） and 18 patients in control group （group B）. The control group received radical mastectomy and at the same time received grafts of full-thickness skins or latissimus dorsi flaps for repairing skin defects. The treatment group received adjacent expanded flaps combined with radical mastectomy. All clinical data, postoperative appearances and feelings of chest walls, and local recurrences were compared between the two groups during peri-operative period. Results All clinical data in the treatment group were better than those in the control group, and the difference were statistically significant（P 〈 0.05）. The postoperative appearances and feelings of chest walls in the treatment group were significantly better than those in the control group, and the differences were statistically significant（P 〈 0.05）. The recurrence rate in the treatment group was lower than that in the control group, and the difference was statistically significant（P 〈 0.05）. Conclusion The application of adjacent expanded flaps in the surgery of LABC has favorable clinical effects and is a safe and effective treatment for LABC, which is worthy of clinical promotion and application.