筋膜下隆乳术与乳腺后间隙隆乳术的临床效果和并发症比较

Comparison study of clinical effect and complications between subfascial and submammary breast augmentation

目的比较筋膜下隆乳术与乳腺后间隙隆乳术的临床效果和并发症的发生情况，以探讨筋膜下隆乳术的临床优势。方法2009年9月至2012年5月，临床完成25例筋膜下隆乳术和31例乳腺后间隙隆乳术。观察比较术后出现的可见的假体边缘或皱褶、乳房上极外形呈凸状和远期继发下移现象，以及血肿、感染和包膜挛缩3种常见并发症的发生率。结果所有病例获术后2—26个月的随访。筋膜下隆乳组和乳腺后间隙隆乳组出现可见的假体边缘或皱褶的发生率分别为4．O％（1／25）和29．0％（9／31），组间比较差异有统计学意义（P〈0．05）；乳房上极呈凸状的发生率分别为8．0％（2／25）和35．5％（11／31），组间比较差异有统计学意义（P〈0．05）；2组均尚未见远期继发下移的现象。2组血肿的发生率分别为4．0％（1／25）和6．5％（2／31）；2组均未见感染的表现；2组包膜挛缩的发生率分别为8．0％（2／25）和12．9％（4／31），组间比较差异无统计学意义（P〉0．05）。结论筋膜下隆乳术与乳腺后间隙隆乳术相比，在临床效果方面有一定的优势，但在发生包膜挛缩等常见的并发症方面尚未见明显的差别。

Objective To compare the clinical effect and complications of subfascial breast augmentation and submammary breast augmentation. Method From Sept. 2009 to May 2012 , 25 patients with subfascial breast augmentation and 31 patients with submammary breast augmentation were observed. The postoperative results including visible implant edge or ripple, upper pole of the implant and long-term implant ptosis were compared respectively. The complications including hematoma, infection and capsular contraction were also recorded. Results 56 cases were followed up for 2 months to 26 months. The incidence rate of visible implant edge or ripple was 4.0% （1/25） in the subfascial group and 29.0% （9/31） in the submammary group, showing a significant difference between them （P 〈 O. 05）. The incidence rate of convex upper pole of the implant was 8.0% （2/25） in the subfascial group and 35.5% （ 11/31 ） in the submammary group, showing a significant difference between them （ P 〈 0.05 ）. Long-term implant ptosis was not found in the two groups. The incidence rate of hematoma was 4.0% （ 1/25 ） in the subfascial group and 6. 5% （2/31） in the submammary group, infection was not found. The incidence rate of capsular contraction was 8.0% （2/25） in the subfascial group and 12.9% （4/31） in the submammary group, showing no statistical difference between them （ P 〉 0.05 ）. Conclusions Subfascial breast augmentation has more clinical advantages compared with submammary breast augmentation, but no evident differenoe was found in the common complication rate, such as capsular contraction.