摘要
目的探讨单蒂横行腹直肌肌皮瓣乳房再造术中Ⅳ区皮瓣的取舍。方法通过16例实施单蒂横行腹直肌肌皮瓣乳房再造术，术中观察皮瓣的皮色、断面出血颜色，并利用近红外血氧监测仪测定皮瓣各区的组织血氧饱和度，决定Ⅳ区皮瓣的取舍。术后观察指标包括术后并发症及美学效果。结果16例中5例Ⅳ皮瓣的肤色正常、断面出血呈鲜红色而非暗红色、组织血氧饱和度不低于Ⅲ区组织血氧饱和度的95％。在接受了保留Ⅳ区皮瓣的单蒂横行腹直肌肌皮瓣乳房再造术后，再造乳房全部成活，无严重术后并发症，患者对再造乳房均很满意。结论近红外血氧无创检测有助于决定Ⅳ区皮瓣的取舍。有选择地实施保留Ⅳ区皮瓣的单蒂横行腹直肌肌皮瓣乳房再造术，可用于大面积胸壁缺损或乳腺尾叶的修复重建。
Objective To study the selective preservation of zone Ⅳ in unipedicled TRAM flap. Method From Jan, 2006 to Jun. 2006, 16 cases underwent breast reconstructions with unipedicled TRAM flaps. We determined the preservation of zone Ⅳ according to the observation of the color of the skin paddle, the color of the cross section and the measurement of tissue oxygen index （TOI） using near infrared spectroscope instrument. Outcome was assessed in the following two aspects： complications and esthetic outcome. Results Among the total 16 cases, 5 cases underwent breast reconstructions with zone Ⅳ preserving unipedicled TRAM flaps under the condition of the skin paddle in normal color, the cross section was red in color, and the TOI of zone Ⅳ was no less than 95% of that in zone Ⅲ. All of these 5 flaps were survived without serious complication, All of these 5 patients were satisfied with their reconstructed breasts. Conclusions The use of near infrared spectroscope instrument is helpful to determine whether it is appropriate to preserve zone Ⅳ in unipedicled TRAM flap. Zone Ⅳ preserving unipedicled TRAM flap can be performed in selected patients to reconstruct a large chest wall defect or the tail of the breast.
出处
《中华医学美学美容杂志》
2007年第2期71-74,共4页
Chinese Journal of Medical Aesthetics and Cosmetology
关键词
横行腹直肌肌皮瓣
乳房成形术
近红外组织血氧分析
单蒂横
Transverse rectus abdominis myocutaneous flap （TRAM flap）
Breast reconstruction
Near-infrared spectroscopy
