探讨供区采用内增压供血在乳腺癌患者术后即刻腹壁下动脉穿支（DIEP）皮瓣乳房重建术中的应用效果。

回顾性分析2024年1月至2025年12月于中国医学科学院北京协和医学院肿瘤医院深圳医院接受保留乳头乳晕的乳房切除术后采用内增压为供血模式的DIEP皮瓣（内增压-DIEP）乳房重建的12例女性乳腺癌患者的临床资料。患者临床分期Ⅰ期3例，Ⅱ期8例，Ⅲ期1例。术前均行CT血管造影以精确定位腹壁下动脉穿支的数量与解剖位置；术中记录供区穿支血管数目、动静脉管径以及用于内增压吻合的血管支数；术后随访评估皮瓣存活率、并发症发生情况，并采用BREAST-Q量表评价重建乳房外形满意度及供受区功能恢复情况。

12例患者均成功施行双蒂DIEP皮瓣移植，皮瓣切取面积为12.0 cm×24.0 cm~14.0 cm×30.0 cm，质量为（759.17±99.91）g，手术时间为（487.67±97.21） min。术中解剖出穿支血管3支者8例，4支者4例；其中8例采用单支动脉内增压供血，4例采用双支动脉内增压供血。内增压动脉管径为（0.75±0.19） mm，静脉管径为（0.94±0.12） mm。术后随访3.0~14.5个月，中位随访时间为6.3个月，移植皮瓣均成活，未出现皮瓣坏死、血肿、感染等围手术期并发症。BREAST-Q量表评分为（91.83±2.52）分，提示患者对重建乳房外形及供受区功能恢复满意度较高；随访期间无局部复发或远处转移事件发生。

在严格筛选适应证的前提下，内增压-DIEP乳房重建术具有一定的安全性、可行性与美学效果，可考虑作为乳腺癌术后即刻乳房重建的一种术式。

To investigate the application value of donor-site perfusion via turbocharging in immediate deep inferior epigastric perforator (DIEP) flap breast reconstruction following breast cancer surgery.

A retrospective analysis was conducted on the clinical data of 12 female patients with breast cancer who underwent nipple-sparing mastectomy followed by immediate DIEP flap breast reconstruction perfused by turbocharging (turbocharged DIEP) in the Shenzhen Hospital of Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College between January 2024 and December 2025. There were 3 cases of stage Ⅰ, 8 cases of stage Ⅱ and 1 case of stage Ⅲ. Preoperative computed tomography angiography (CTA) was performed in all patients to accurately locate the number and anatomical positions of DIEP. The number of donor perforator vessels, the diameters of arteries and veins, and the number of vessels used for turbocharging anastomosis were systematically recorded during surgery. Postoperative follow-up was conducted to assess flap survival rate and the incidence of complications, and the BREAST-Q Questionnaire was used to quantitatively evaluate patient satisfaction with reconstructed breast appearance and functional recovery of the donor and recipient sites.

Double-pedicle DIEP flap transplantation was successfully performed in all 12 patients. The flap harvest area ranged from 12.0 cm×24.0 cm to 14.0 cm×30.0 cm, with an average weight of (759.17±99.91) g and operative time of (487.67±97.21) min. Intraoperative anatomical dissection identified 3 perforator vessels in 8 cases and 4 perforator vessels in 4 cases; among them, single-artery turbocharging was used in 8 cases and double-artery turbocharging in 4 cases. The diameter of turbocharged arteries was (0.75±0.19) mm, and the venous diameter was (0.94±0.12) mm. All patients were followed up for 3.0-14.5 months with a median follow-up of 6.3 months. All transplanted flaps survived completely, with no perioperative complications such as flap necrosis, hematoma or infection. The mean BREAST-Q score was (91.83±2.52), indicating high patient satisfaction with the appearance of reconstructed breasts and the functional recovery of donor and recipient sites. No local recurrence or distant metastasis occurred during the follow-up period.

Under strict patient selection, turbocharged-DIEP breast reconstruction has good safety, feasibility and aesthetic effects, which can be used for immediate breast reconstruction after breast cancer surgery.