【摘要】 目的 研究腺体大部切除乳房成型术治疗重症乳腺增生症合并巨乳症的临床治疗效果。方法 45例重症乳腺增生合并Ⅲ级巨乳症患者，采用自行设计的“腺体大部切除乳房成型术”进行手术治疗，并观察疗效1～12年。结果 患者对成型后乳房的外形“很满意”者41例，“较满意”者4例，满意率100%。残余腺体中仍可触及结节样增生性病变者，3个月内为12例，1年后全部消失。手术后有月经前乳腺疼痛主诉者，3个月内为10例，1年后无主诉。残余乳腺组织中出现硬性团块者15例，其中6例经热敷、理疗后3个月缓解。28例术后1～2年内出现双侧乳房松软张力降低，钼靶X线摄片提示为“腺体退化表现”。全部病例术后1～4个月起，原“乳腺增生”无需应用药物治疗。结论 重症乳腺增生合并Ⅲ级巨乳症患者接受了本手术后，原增生性病变减轻；原乳腺钼靶X线片提示“腺体高密度阴影”、临床触及的“硬性腺体结节”，均有了可靠的病理。术后1～2年随访提示，成型乳房内余留的增生性结节明显软化，张力下降，组织松软，疼痛消失；成型后乳房外形符合女性生理形态，原赘重性巨乳缓解，近期及远期临床效果满意。

    【关键词】 乳腺增生；腺体切除；乳房成型

    The study on operation method of gigantomastia combined severity hyperplasia with majority mastectomy and immediate breast mammoplasty

    JIN Zong-hao.

    Department of Breast Surgery,Tongji Hospital of Tongji University,Shanghai 200065,China

    【Abstract】 Objective To investigate the gigantomastia combined severe hyperplasia with majority mastectomy and immediate breast molding.Methods 45 cases of Ⅲ degree gigantomastia were majority mastectomy and immediate breast molding.All cases have observed after operation for

    1～12 years.Results After operation,100% of patients perceived contentment.Forty-one cases were very satisfied and four satisfied with their aesthetic outcome after operation,eighteen were not found mass.Twenty-seven cases were found mass.But mass was diminished in twelve cases after one to two years without medicament treatment and fifteen with physiotherapy.Conclusion Majority mastectomy combined immediate breast molding could effectively manage the gigantomastia combined severity hyperplasia with satisfied aesthetic outcome. ......