环乳晕小切口治疗男性乳腺发育症24例临床研究

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[摘要] 目的 探讨环乳晕小切口治疗男性发育症的可行性及临床疗效。 方法 在局部肿胀麻醉或合并静脉镇痛麻醉下，对24例青年男性发育患者经环乳晕小切口（2 cm左右）切除皮下乳腺。 结果 24例手术均获成功。术中未出现并发症。手术时间平均47.2 min（单侧），全组术后伤口均为甲级愈合，无感染、皮下气肿、血肿、乳晕坏死等并发症，24例经6～36个月随访，胸廓平整，外观良好，切口瘢痕不明显，、乳晕无内陷，感觉无异常可，所有患者对手术美容效果表示满意。 结论 环乳晕小切口手术治疗青年男性发育症切口微小隐蔽，美容优势明显，患者生活质量提高。

[关键词] 环乳晕切口；小切口；美容；男性发育症

[中图分类号] R655.8 [文献标识码] A [文章编号] 1673-7210（2012）08（a）-0054-03

24 cases of surgical observation of gynaecomastia by small circum-areola incision

HUO Yongping1 YAN Liting2 ZHANG Yingzhou1 ZHU Qingfen1 LI Fei1

1.Department of Mammary Gland Surgery, the Central Hospital of Handan City, Hebei Province, Handan 056000, China; 2.Second Department of Gynaecology, the Central Hospital of Handan City, Hebei Province, Handan 056000, China

[Abstract] Objective To investigate the feasibility and effect on surgery of gynaecomastia by small circum-areola incision. Methods The subcutaneous mammary gland tissue of 24 cases of young male gynaecomatia was resected by using small circum-areola incision about 2 mm with tumescent anesthesia (some with vein analgesia anaesthesia also). Results The operation was successfully performed in 24 patients. The mean operating time was 47.2 min (one-side). All wounds were healed in grade A, and all patients without any complication such as infection, subcutaneous emphysema, hematoma, nipple-areola necrosis. During 6 to 36 months follow-up, nomal thoracic shapes were achieved, the configuration of the breasts were well, the scars were obscure, the nipple-areola had no depression. The sensation and erection of nipples remained normal in all patients. And they all were greatly satisfied with the cosmetic outcome of the operation. Conclusion The operation for young male gynaecomastia by small circun-areola incision is well, the incision is small and conceling, the cosmetic results are excellent, which raises the quality of life of the patients.

[Key words] Circun-areola incision; Micro-incision; Cosmetology; Gynaecomastia

男性发育症（gynecomastia，GYN）又称男性乳腺增生症或男子女性型，是男性最常见的乳腺疾病，文献报道占男性乳腺疾病的40%～65%[1]，Braunstein[2]报道尸检发现率为40%～55% 。表现为男性乳腺组织异常发育肿大，伴或不伴疼痛，可暂时发生，也可为永久性[3]。近年来随着生活水平提高，生活模式转变，该病发病率和就诊率有明显升高的趋势。患者尤其是青年患者不仅要求治愈疾病本身，还要求术后获得满意的男性胸廓外形。本研究的背景就是美容外科领域日益受重视的一个概念的提出——体象障碍，它是指患者对其外表不存在的或轻微的缺陷的一种痛苦或有害的先占观念，它常导致社会交往退缩、工作能力下降和一些不必要的医疗过程，甚至会引起自杀行为[4]。笔者的研究目的是通过微创治疗，达到最大限度的美学效果，验证该种术式的可行性。传统手术方式的切口大、术后瘢痕影响外观等缺点，给患者造成较大的心理压力，易产生体体象障碍。我科采取环乳晕小切口潜行切除增生乳腺组织，治疗男性发育患者24例44侧，随访方式：电话邀患者返院复查，随访6～36个月，手术效果满意，现将资料总结报道如下：