摘要
目的 比较运用横行带蒂腹直肌肌皮瓣（transverse rectus abdominis myocutaneous flap,TRAM flap）和背阔肌肌皮瓣（latissimus dorsi flap,LDF）进行I期乳房再造术的并发症（包括脂肪坏死率、肌皮瓣部分坏死率、肌皮瓣完全坏死率）,为临床决策提供依据.方法 在CNKI、SinoMed、PubMed、VIP、Cochrane等数据库和运用手工检索1992～2012年有关带蒂TRAM肌皮瓣及LDFI期乳房再造的中英文文献共1493篇.按照纳入与排除标准选择、提取资料和评价质量后,发现有47篇文献符合标准,采用RevMan 5.0软件进行M-H固定效应模型进行Meta分析.结果 有10篇文献同时包含带蒂TRAM肌皮瓣和LDF乳房再造并发症,所以用以比较两者的并发症的相关危险度（relative risk,RR）和95％置信区间（confidence interval,CI）.带蒂TRAM肌皮瓣的部分坏死率是LDF的1.7倍（RR值为1.72,95％CI为1.02～2.88）,脂肪坏死率（RR值为1.01,95％CI为0.60～1.72）和肌皮瓣完全坏死率（RR值为2.13,95％CI为0.82～5.54）,与LDF相比差异无统计学意义（P＞0.05）.结论 LDF与带蒂TRAM肌皮瓣乳房再造术相比,LDF乳房再造的肌皮瓣部分坏死并发症发生率较低,肌皮瓣完全坏死率与脂肪坏死率比较,差异无统计学意义（P＞0.05）.
Objective To analyze the complications of breast reconstruction with pedicled transverse rectus abdominis myocutaneous flap （TRAM flap） and latissimus dorsi flap （LDF）.Methods From databases such as CNKI,SinoMed,PubMed,VIP and Cochrane Library and manual search of articles on breast reconstruction with pedicled TRAM and LDF from 1992 to 2002 for the language of both Chinese and English,1493 cases were collected.47 cases were selected after they all were inspected by the excluded and included standards.RevMan 5.0 software was used to perform the Mantele-Haenszel fixed effect model.Results Ten studies reporting outcomes of pedicled TRAM and LDF were used to estimate relative risk （RR） and 95 % confidence interval （CI） for complications.There was a 1.7 times increase in the risk of partial flap necrosis （relative risk,1.72; 95 % CI,1.02to 2.88） in pedicled TRAM flap patients compared with LDF patients.There was no difference in the risk for fat necrosis （relative risk,1.01; 95 % CI,0.60 to 1.72） and total flap loss （relative risk,2.13; 95 % CI,0.82 to 5.54） between pedicled TRAM flap and LDF patients （P〉0.05）.Conclusions Compared with the pedicled TRAM flap,partial flap loss risk of breast reconstruction with LDF is lower,and the risk of fat necrosis and total flap loss have no statistical difference （P〉0.05）.
出处
《中华医学美学美容杂志》
2013年第5期326-330,共5页
Chinese Journal of Medical Aesthetics and Cosmetology
