自体脂肪移植结合假体置入在乳腺癌改良根治术后乳房重建中的应用

Application of Autologous Fat Transplantation Combined with Prosthesis Implantation in Breast Reconstruction after Modifi ed Radical Mastectomy for Breast Cancer

目的:探讨自体脂肪移植结合假体置入在乳腺癌改良根治术后乳房重建中的应用效果及其对乳房美观度的影响。方法:纳入2019年1月-2020年1月笔者医院收治的70例乳腺癌患者,根据非随机临床同期对照研究及患者自愿原则将其分为对照组(n=32)和研究组(n=38),分别于乳腺癌改良根治术后即刻行假体置入或自体脂肪移植结合假体置入进行乳房重建,观察其临床治疗情况,于术后3个月采用泽井法评价患者乳房美观度,通过随访调查患者满意率及术后并发症发生情况。结果:两组患者均顺利完成手术。研究组与对照组假体容积填充量分别为[(201.35±20.19)ml和(210.20±19.55)ml],组间比较差异无统计学意义(P>0.05)。手术时间分别为[(152.70±30.50)min和(130.35±25.10)min]、手术前后乳头水平最大吸气胸围量差值分别为[(6.23±0.2)cm和(5.50±0.18)cm],差异均有统计学意义(P<0.05)。术后3个月,两组乳房美观度均较术前明显改善,研究组优良率显著高于对照组,且研究组患者满意率(89.47%)显著高于对照组(68.75%),差异有统计学意义(P<0.05)。两组术后并发症发生率比较差异无统计学意义(P>0.05)。结论:与单纯假体置入相比,应用自体脂肪移植结合假体置入进行乳房重建,能获得更好的外观美学效果,患者满意度高,术后并发症少,值得临床推广应用。

Objective To investigate the eff ect of autologous fat transplantation combined with prosthesis implantation in breast reconstruction after modifi ed radical mastectomy for breast cancer and its impact on breast aesthetics.Methods This study included 70 breast cancer patients in the hospital between January 2019 and January 2020.The patients enrolled were divided into the control group(n=32)and the study group(n=38)according to the non-randomized clinical concurrent controlled study and the principle of voluntariness.The patients in the control group received modifi ed radical mastectomy combined prosthesis implantation,while those in the study group treated with both autologous fat transplantation and prosthesis implantation after modifi ed radical mastectomy.The clinical treatment was observed,and breast appearance was evaluated by Zejing method at 3 months after operation.Follow-up was conducted to observe patient satisfaction and the occurrence of postoperative complications.Results All patients enrolled underwent surgery successfully.The fi lled prosthesis volume of the study group and the control group was(201.35±20.19)ml and(210.20±19.55)ml,there was no signifi cant diff erence between groups(P>0.05).The operation time of the study group was longer than that of the control group[(152.70±30.50)min vs(130.35±25.10)min,P<0.05].And the diff erence of the maximum inspiratory chest circumference of the nipple level before and after operation of the study group was greater than that of the control group[(6.23±0.2)cm vs(5.50±0.18)cm,P<0.05].Three months after operation,the beauty of breasts in both groups was significantly improved compared with that before operation.The excellent and good rate of the study group was signifi cantly higher than that of the control group(P<0.05).The patient’s satisfaction rate of the study group was signifi cantly higher than that of the control group(89.47%vs 68.75%,P<0.05).There was no signifi cant diff erence in the incidence of postoperative complications between the two groups(P>0.05).Conclusion Compared with prosthesis implantation alone,autologous fat transplantation combined with prosthesis implantation used for breast reconstruction and shaping can achieve better appearance and cosmetic results,with high patient’s satisfaction and few postoperative complications.