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多层螺旋CT血管造影术在腹壁下动脉穿支皮瓣乳房重建中的应用

[Application of MDCT angiography for breast reconstruction with deep inferior epigastric artery perforator flaps].

作者信息

Xin Min-Qiang, Mu Lan-Hua, Luan Jie, Mu Da-Li, Su Wei-Zhen

机构信息

Breast Plastic and Reconstructive Surgery Center, Plastic Surgery Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100144, China.

出版信息

Zhonghua Zheng Xing Wai Ke Za Zhi. 2010 Sep;26(5):351-3.

Abstract

OBJECTIVE

To investigate the significance of preoperative MDCT angiography for breast reconstruction with abdominal flap.

METHODS

Preoperative MDCT angiography scans were performed on 34 patients who underwent breast reconstruction with abdominal flaps during December 2006 to June 2009. The operation was designed based on the MDCT results. Then the MDCT results were proved intraoperatively. Another 22 cases who underwent breast reconstruction with abdominal flap without preoperative MDCT were selected as controls. The rate of operative method change, the operation time and the flap necrosis were compared between the two groups.

RESULTS

The preoperative design changed in 23.53% of the patients, based on the MDCT results. No one had any method change intraoperatively in the group with MDCT. The operative method was changed intraoperatively in 13.64% of the patients in the control group. The mean time spending on flap harvesting was (2.51 +/- 0.64) h in the experimental group and (4.42 +/- 0.21) h in the controlled group (P < 0.05). The rate of complication was 6.12% in the experimental group and 12.5% in the control group (P = 0.017).

CONCLUSIONS

Preoperative MDCT angiography is an easy and reliable method for breast reconstruction with abdominal flap. The preoperative design can be more reasonable. It helps to save the operation time and reduce the risk.

摘要

目的

探讨术前多层螺旋CT血管造影(MDCTA)在腹直肌肌皮瓣乳房重建术中的意义。

方法

对2006年12月至2009年6月期间行腹直肌肌皮瓣乳房重建术的34例患者进行术前MDCTA扫描,根据MDCT结果设计手术方案,并在术中验证MDCT结果。另选取22例未行术前MDCT的腹直肌肌皮瓣乳房重建患者作为对照组。比较两组手术方法改变率、手术时间及皮瓣坏死情况。

结果

基于MDCT结果,23.53%的患者术前设计发生改变。MDCT组术中无患者手术方法改变。对照组13.64%的患者术中手术方法发生改变。实验组皮瓣切取平均用时(2.51±0.64)小时,对照组为(4.42±0.21)小时(P<0.05)。实验组并发症发生率为6.12%,对照组为12.5%(P = 0.017)。

结论

术前MDCTA是一种简便、可靠的腹直肌肌皮瓣乳房重建方法,可使术前设计更合理,有助于节省手术时间、降低风险。

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