目的 探讨采用超声辅助自制支架牵引矫正乳头内陷的疗效。方法 回顾性分析2012-01至2016-03期间在北京妇产医院诊治的60例先天性乳头内陷患者临床资料,随机分为对照组和研究组。研究组31例采用超声辅助自制支架牵引术。对照组29例无超声辅助直接采用支架牵引治疗,对比两组的手术时间及疗效。结果 研究组手术时间为(14.2±2.9) min,术后即刻乳头高度为(11.5±2.9) mm;对照组患者手术时间为(17.4±1.6) min,术后即刻乳头高度为(8.3±1.7) mm。两组相比,前者手术时间更短(P<0.001),乳头高度更大(P<0.001);研究组术后疗效好57例,中3例,对照组术后疗效好48例,中10例。研究组无乳头血运障碍,无乳头坏死发生,对照组有2例血运障碍,其中1例乳头部分坏死。两组相比,前者术后疗效更好,且无并发症。差异有统计学意义(P<0.001)。结论 采用超声辅助支架法矫正器持续牵引治疗乳头内陷,操作简便,是一种微创无痕、疗效可靠、安全的治疗方式。
Abstract
Objective To explore the effectiveness of ultrasound assisted traction treatment for correction of inverted nipples.Methods The clinical data of sixty patients with inverted nipples treated at our hospital between January 2012 and March 2016 was retrospectively analyzed. Thirty-one of these patients(60 inverted nipples)received ultrasound assisted traction treatment and 29 patients (58 inverted nipples)were treated with traction alone.The duration of surgery and nipple height immediately after surgery in the two groups were analyzed.Results The duration of surgery was (14.2±2.9) min, nipple height (11.5±2.9)mm in the ultrasound assisted traction group,compared with (17.4±1.6)min and (8.3±1.7)mm in the traction alone group. Shorter duration of surgery and higher nipples were observed in the former group(P<0.001,P<0.001).In the ultrasound assisted traction group, the result of treatment was found perfect in 57 cases, good in 3 cases, and bad in none,compared to 48,10 and 0 in the traction alone group.There was no case of nipple blood supply obstacles or nipple necrosis in the former group, but 2 cases of blood supply obstacles and 1 case of nipple partial necrosis in the control group. The therapeutic effect was better in the former group without any complications.The difference was statistically significant (P<0.001).Conclusions Ultrasound assisted continuous traction with self-made tractors is a good approach to each type of inverted nipples. It is a simple, safe, effective, and minimally invasive without any scar.
关键词
乳头内陷 /
支架法 /
超声辅助 /
持续牵引
Key words
inverted nipple /
tractor /
ultrasound-assisted /
continuous traction
{{custom_sec.title}}
{{custom_sec.title}}
{{custom_sec.content}}
参考文献
[1] Alexander J M, Campbell M J.Prevalence of inverted and non-protractile nipples in antenatal women who intend to breast-feed[J].The Breast,1997,6:72-78.
[2] 龙 笑,赵 茹,王晓军.矫正器持续牵引法治疗乳头内陷并发症分析[J].中华整形外科杂志,2013,29(1),15-17.
[3] Han S,Hong Y G.The inverted nipple:its grading and surgical correction[J].Plast Reconstr Surg,1999,104(2):389.
[4] 陈育哲,王玉珏,王大玫.埋线荷包缝合法加外牵引矫正乳头凹陷[J].中国微创外科杂志,2001,1(2):101.
[5] Ming J, Meng G, Yuan Q.Clinical characteristics and surgical modality of plasma cell mastitis: analysis of 91 cases[J].Am Surg,2013,79(1):54-60.
[6] Park H S,Yoon C H,Kim H J.The prevalence of congenital inverted nipple[J].Aesth Plast Surg,1999,23(2):144.
[7] 苏光明,董晓明,夏 隽,等.乳头内陷的超声诊断探讨[J].中国医学影像学杂志,2003,11(3):207-209.
[8] Kehrer F A.Uber excision des werzenhofS bei hohlwerzen.Beitr Exp Geburtshilfe Gynaekol[J].Gizessen,1879,43:170.
[9] Xiao L,Ru Z.Nipple retractor to correct inverted nipples[J].Breast care,2011;6:463-465.
[10] Dali M,Jie L,Lanhua M,et al.A minimally invasive gradual traction technique for inverted nipple correction[J].Aesth Plast Surg,2012,36:1151-1154.
[11] 栾 杰,陈 莉,张旭辉,等. 一种乳头内陷矫正术后维持固定乳头方法[J].中华整形外科杂志,2002,18(6):329.
[12] Hester T R Jr,Bostwick J, Miller L,et al.Breast reduction utilizing the maximally vascularized central breast pedicle[J]. Plast Reconstr Surg, 1985,76(6):890-900.
[13] 马海欢,Muller G H.改良乳房下真皮乳腺单蒂瓣巨乳缩小术[J].中华整形烧伤外科杂志,1998,14(1):30-32.
[14] Tracy C A,Pool R,Gellis M,et al.Blood flow of the areola and breast skin flaps during reduction mammaplasty as measured by laser Doppler flowmetry [J].Ann Plast Surg,1992,28(2):160-166.
基金
首都医科大学附属北京妇产医院,中青年学科骨干培养专项(fcyy201429)
PDF(2783 KB)
