PRS:DIEP皮瓣乳房再造中采用神经吻合可改善乳房感觉恢复

2021-08-12 网络 网络

乳房再造的基本要求是恢复美观的乳房外形,在这一基础上追求实现功能再造,改善再造乳房的感觉。

 乳房再造的基本要求是恢复美观的乳房外形,在这一基础上追求实现功能再造,改善再造乳房的感觉。 故此,本前瞻性研究的目的是分析与非神经DIEP皮瓣乳房再造相比,受神经支配的乳房以及供区的感觉恢复情况,评估与感觉恢复相关的因素,并评估术前和术后感觉之间的差异。 图1.文章摘要图 该研究共纳入125例于2016年8月至2018年8月期间接受该治疗的成年女性。这些患者均接受了单侧或者双侧DIEP乳房再造,均未保留乳头乳晕。 其中DIEP皮瓣组共有67名患者,94个神经支配的DIEP皮瓣。非神经支配DIEP组共有58名患者,80个非神经支配DIEP。81例非手术乳房作为正常乳房感觉的参考。 中位随访时间分别为15个月(神经支配DIEP)和16个月(非神经支配DIEP)。 手术中,需作神经吻合的供体神经是第十至第十二肋间神经的感觉分支。受体神经通常是第二或第三肋间神经前皮支。端对端神经吻合用9-0尼龙线,不使用神经导管或其他移植物。吻合时间约为15分钟。 在神经评估中,通常在手术前1天和术后6周、3月、6-9月和12-15月进行Semmes-Weinstein单丝测试(1.65到6.65

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    2021-09-14 kzlchina
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    2021-08-14 sunylz
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    2021-08-14 lg.zhao
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