假体隆乳术后包膜挛缩的微生物学实验研究

Experimental study of capsular contracture following the breast augmentation in microbiology

目的通过对取自隆乳患者的假体包膜的微生物培养及电镜检测，研究包膜挛缩与微生物寄居的关系。方法要求取出假体的女性患者40例58侧，其中发生挛缩38侧，未挛缩20侧。对取出的假体包膜进行微生物学培养及电镜检测，其中微生物培养采用两种方法：其一为传统的一般微生物学检测；其二为对取出的假体包膜进行超声震荡，再将滤液进行微生物学检测。结果超声震荡微生学培养结果显示：未发生挛缩的假体包膜检测到细菌的阳性率为10％，发生挛缩的检测到细菌的阳性率为53％，差异有统计学意义（P〈0．05）。其中胸大肌下检测到的阳性率为58％，乳腺下为53％，差异无统计学意义（P〉0．05）。挛缩假体包膜的一般微生物培养结果显示，阳性率为8％，与发生挛缩的包膜超声滤液微生物培养阳性率的53％相比，差异具有统计学意义（P〈0．05）。对13侧发生挛缩的假体包膜进行电镜扫描，7侧发现表皮葡萄球菌广泛存在。结论与未发生挛缩的假体及其包膜相比，其具有更高的细菌寄居率。胸大肌下与乳腺下的假体细菌寄居率无差异。超声震荡能显著提高细菌培养的检出率。

Objective To explore the relation between capsular contracture and microorganism colonization by means of microbial culture and electronic microscope scanning on the fibering capsule. Methods The prosthesis and capsule were taken from 40 female patients with contracture （38 cases） and non-contract ure （20 cases） and then were detected by microbiological culture and electron microscopy examination. The microbiological culture included two kinds of methods, one was detected directly by general germicuhure, and the other one was detected by the same way after ultrasound concussion. Results The results after ultrasound concussion showed the positive rates of bacteria in patients with and without capsular contracture were 53% and 10% respectively, there was statistical significance in difference （ P〈0.05 ） ; the positive rates of bacteria under pectoralis major muscle and mammary glands were 58% and 53% respectively, there was no statistical significance in difference. Compared with the detection after ultrasound concussion, the positive rate of bacteria detected directly by general germicuhure was only 8%, there was statistical significance in difference （ P 〈 0.05）. Electronic microscope scanning results in 13 patients with capsular contracture displayed that staphylococcus epidermidis existed widely on the surface of the 7 of 13 contracted capsule. Conclusion Comparing with capsule without contracture, there is higher living rate of bacteria existing in the capsule with contracture. There is no difference in bacteria living rate between pectoralis major muscle and mammary glands. The way after ultrasound concussion can improve the detection rate.