女性乳腺癌全乳切除术后乳房假体一步法及两步法重建效果比较

One-step and two-step reconstruction of breast prostheses after total mastectomy of breast cancer: a comparative study of 62 cases

关键词:  乳腺癌  假体  重建  临床分析

Key words:  breast cancer  prosthesis  reconstruction  clinical analysis

摘要:

目的探讨女性乳腺癌术后采用假体一步法和两步法（扩张器/假体）重建的临床经验及应用价值。方法收集乳腺癌术后假体一步法重建30例及两步法重建32例患者临床资料，比较分析其围手术期治疗结果、重建效果以及随访结果。结果两组患者围手术期在年龄、肿瘤直径、乳房容量、体重指数、病理分期、病理类型及乳头保留情况均无明显差异，但在补片使用上乳房假体一步法重建上明显多于两步法，差异有统计学意义（P<0.05）。两组患者总体并发症发生率差异无统计学意义（P>0.05），住院时间差异有统计学意义（P<0.01）。术后Harris乳房美容效果及患者自身对术后的满意度进行主观评价，两组差异无统计学意义（P>0.05）。采用乳腺癌生命质量测定对两组患者治疗后生存质量评分比较，内容包括生理状况、社会家庭状况、情感状况、功能状况和附加关注维度得分，两组间差异均无统计学意义。结论总体并发症和术后效果上乳房假体一步法与两步法重建相似，重建方式的选择仍需要依据患者的意愿、美观预期、体质状况等多种个体化因素。

Abstract:

ObjectiveTo compare the efficacy of one-step prosthesis reconstruction and two-step prosthesis reconstruction for patients with breast cancer. MethodsClinical data of 30 patients with breast cancer receiving one-step breast reconstruction and 32 patients receiving two-step breast reconstruction were analyzed. ResultsThere were no significant differences in age, tumor diameter, breast volume, body mass index, pathological stage, pathological type and nipple retention between the two groups during the perioperative period. However, patch using in one-step reconstruction of patients was significantly more than that in two-step reconstruction patients(P<0.05). There was no significant difference in the overall incidence of complications between the two groups(P>0.05). There was significant difference in the length of hospital stay between the two groups(P<0.01). There was no significant difference between the two groups in the scores of quality of life(QOL) after treatment, including physiological status, social and family status, emotional status, functional status and additional attention dimension. ConclusionThe overall complications and postoperative effects of two-step reconstruction of breast prosthesis are similar to that of one-step reconstruction. The choice of reconstruction mode needs to be based on the patient’s wishes, aesthetic expectations, physical condition and other individual factors.