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目的 总结和探讨乳腺癌保乳手术保持乳房良好外形 ,在术前、术中和术后应注意的问题。方法 3 7例患者接受了乳腺癌保乳手术。术后从乳头外观、双乳头水平差距、双乳头距同侧腋前线垂直距离之差距和瘢痕对乳房外形影响等四个方面的量化标准 ,评估保留乳房的外形美观效果。四项指标积分≥ 2 1分为优 ,13～ 2 0分为良 ,<13分为差。结果 术后保留乳房外形优良者 3 0例 ( 81.1% ) ,乳房外形较差者 7例 ( 18.9% )。常见问题是因切口瘢痕致乳房变形、乳头歪斜、乳头不自然挺立 ,以及与对侧乳头水平高度差距明显。结论 术前认真设计手术切口、术中注意术区皮瓣和保留乳腺组织的彻底游离以及切除、缝合技巧 ,术后切口包扎时注意避免压迫乳头等 ,将有助于保持保留乳房的外形美观效果
Objective To summarize and discuss the breast-conserving surgery breast-conserving surgery to maintain a good shape, preoperative, intraoperative and postoperative should pay attention to the problem. Twenty-three patients underwent breast conserving surgery. After the operation, we quantified the appearance of the breast by four quantitative criteria, including the appearance of the nipple, the level difference of the double nipples, the distance between the two nipples and the vertical distance of the axillary line of the same side and the influence of the scar on the shape of the breast. Four indicators of integral ≥ 2 1 divided into excellent, 13 to 20 points for the good, <13 points for the poor. Results There were 30 cases (81.1%) with excellent breast shape and 7 cases (18.9%) with poor breast shape after operation. Common problems are due to incision scar deformation of the breast, nipple skew, nipple does not stand upright, and contralateral nipple height difference significantly. Conclusions Preoperative careful design of surgical incision, intraoperative attention to the flap and breast tissue surgery to keep the complete free and resection, suture techniques, postoperative incision dressing to avoid oppression nipple, etc., will help to keep the appearance of the breast aesthetic effect