| Objective: To delay breast reconstruction with the pedicled transverse rectus abdominis myocutaneous flap(TRAM)and then perform intervention of intravenous administration of safflower injection in patients with breast carcinoma,and to do observation and analysis on the blood circulation of flap in early stage and the long-term cosmetic effect,which was in order to explore the effect of drug intervention of the safflower injection on preoperative delay phenomenon of breast reconstruction with TRAM flaps,and the influence of blood circulation of flaps,aiming to provide preliminary basis for adopting feasible pretreatment before the breast reconstruction with TRAM flaps to improve the blood circulation of flaps.Methods: Inpatients,who were pathologically diagnosed with breast carcinoma in XX TCM hospital of china and have decided to accept pedicled breast reconstruction with TRAM flaps from March 2014 to October 2015,were taken as the study objects.A total of 30 patients were randomly divided into 2 groups according to admission ID.The treatment group(n=15)was to do pedicled breast reconstruction with TRAM flaps after giving 14 days of safflower injection under the circumstances of inferior epigastric vessels were blocked.The control group(n=15)received the same surgical procedures except giving 14 days of safflower injection.Detection of artery diameter,resistance index and hemodynamic indexes of superior epigastric artery before inferior epigastric vessels were blocked and after 3 days,7 days and 14 days were carried out to observe the blood circulation of flaps in early stage after breast reconstruction with TRAM flaps and the postoperative long-term cosmetic effect.To sum up the above three points,to evaluate the influence of safflower injection on the delay phenomenon and the blood circulation of flaps.Results: The diameter(D)of the lateral pedicled abdominal artery increased and the resistance index(RI)decreased in the safflower injection intervention group(the treatment group)and the control group(P<0.05),but the effect of the safflower injection intervention group was more obvious.In terms of hemodynamic indexes,the ascending blood plasma viscosity,descending erythrocyte electrophoresis rate,increased fibrinogen concentration and high erythrocyte sedimentation rate(ESR)were observed in the treatment group and control group,but the variation ranges in the treatment group was smaller than that in the control group,for this reason,the positive intervention of treatment group on postoperative hemodynamics flow is superior to that of the control group(P<0.05).Analysis of general condition of flaps in early stage after breast reconstruction with TRAM: There were significant differences in comparing degree of colour,swelling and temperature of flaps in the treatment group and control group within 10 days after operation(p<0.05),which meant general condition of flaps in early stage of the treatment group were superior to the control group.But there were no significant differences in comparing degree of survival of flaps and wound healing condition on the 3rd days after operation,blood supply in 2 months after operation,cutaneous sensation of flaps on the 6th mouth after operation and cosmetic result of breast reconstruction between the two groups(p>0.05),which implicated that the condition on survival of flaps,blood supply,cutaneous sensation and cosmetic result of the treatment group were not superior to the control group.Conclusion:In conclusion,Positive intervention function of the safflor injection intervention group on postoperative blood rheology was better than the control group,which suggested that safflower injection had a positive intervention effect on delayed operation before breast reconstruction with TRAM.But,from the long-term effects on flaps,it cannot consider that the safflor injection intervention group was superior to the only delaying operation group.However,findings from effect s of safflor injection in the breast reconstruction surgery provided a preliminary idea and basis for improving blood supply of flaps and performing what kind of proper pretreatment. |
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