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目的探讨乳腺癌改良根治术中皮瓣厚度的选择,降低术后并发症发生率。方法对2008年1~12月河南省人民医院乳腺外科78例行乳腺癌改良根治术的临床资料进行回顾性分析。将2008年1~6月的病人设为Haagensen皮瓣组,2008年7~12月的病人设为胸壁浅筋膜外组,对两组病人术中出血量、手术时间及术后并发症发生率进行对比研究。结果胸壁浅筋膜外组的手术中出血量、手术时间、手术后总引流量及术后皮瓣坏死发生率均低于Haagensen皮瓣组,差异有统计学意义(P<0.05);手术后皮下积液发生率两组相比差异无统计学意义(P=0.522)。结论选择在紧贴胸壁浅筋膜浅层外侧的脂肪层中游离皮瓣,可有效降低乳腺癌根治术后并发症发生率。
Objective To investigate the choice of flap thickness in modified radical mastectomy to reduce the incidence of postoperative complications. Methods The clinical data of 78 cases of modified radical mastectomy for breast cancer in Department of Breast Surgery, Henan Provincial People’s Hospital from January to December in 2008 were retrospectively analyzed. The patients from January to June 2008 were treated as Haagensen flaps. The patients in July and December 2008 were treated as superficial fascia of the chest wall. The intraoperative blood loss, operation time and postoperative complications occurred in both groups Rate of comparative study. Results The blood loss, operation time, postoperative total drainage and the incidence of postoperative flap necrosis were significantly lower than those in Haagensen flap group (P <0.05). After operation The incidence of subcutaneous effusion was no significant difference between the two groups (P = 0.522). Conclusion The free flap in the fat layer close to the superficial layer of the superficial fascia of chest wall can reduce the incidence of postoperative complications of breast cancer.