假体隆乳术后护理措施对预防光面假体移位的临床体会

Clinical experience of nursing measures after augmentation mammaplasty to prevent smooth prosthesis displacement

目的 探寻假体隆乳术后护理措施对预防光面假体移位的效果。方法 收集2019年06月至2020年12月在四川米兰柏羽医学美容医院行经腋路内窥镜辅助下假体隆乳术,并选择光面假体的612例患者。嘱所有患者术后均穿戴塑形衣或者运动绷带(穿戴干预措施)三月,一个月内不能做乳房的按摩或者趴床(行为干预措施),将既有穿戴干预措施又有行为干预措施视为对照组,其他未想遵医嘱仅有穿戴或者行为干预措施和两种措施都没有的组别视为实验组,门诊或视频复查患者出院后三天,一周、一个月、三个月、半年患者是否遵医嘱并记录患者乳房假体移位情况。结果 完成随访379例,其中有27例(7.12%)发生的不同程度的移位,其中20例发生在一个月之内,7例发生在一个月至三个月之间,三个月后无新增假体移位病例;遵医嘱既穿戴了塑形内衣或绷带(穿戴干预措施),又没有按摩或者趴床(行为干预措施)的总共246例,其中发生移位的有6例,假体移位率为2.4%;而没有按摩或者趴床,也没有穿戴塑形内衣或绷带(仅有行为干预措施)的共15例,有3例发生移位,移位率为20%,两组差异具有统计学意义(20%VS 2.4%,P <0.001)。遵医嘱穿戴塑形内衣或绷带,但有过不同程度的按摩或者趴床的(仅穿戴干预措施)总共有107例,其中发生移位的有10例,移位率为9.3%,和既有穿戴干预措施和行为干预措施组比较差异有统计学差异(9.3%VS 2.4%,P=0.004)。既未穿戴塑形内衣或绷带,同时又有按摩或者趴床的(未行干预措施)总共有11例,其中8例发生移位,移位率为72.7%,和既有穿戴干预措施和行为干预措施组相比差异有统计学意义(72.7%VS 2.4%,P <0.001)。结论 术后穿戴塑形内衣或绷带结合早期内不做乳房按摩或者趴床护理措施对预防光面假体移位有积极作用。

Objective To explore the effect of nursing measures after breast augmentation on the prevention of smooth prosthesis displacement.Methods From June 2019 to December 2020,612 patients who underwent transaxillary endoscopic-assisted prosthetic breast augmentation in Sichuan Bravou Plastic Surgery Hospital and selected smooth prosthesis were collected.All patients were instructed to wear shaping clothing or sports bandages(wearing interventions)for three months after surgery,and not to do breast massage or lying on the bed(behavioral interventions)within one month.For the control group,the other groups that did not follow the doctor's advice and only had wearing or behavioral interventions and neither of the two measures were regarded as the experimental group.The patients who were discharged from the outpatient clinic or video review three days,one week,one month,three months,and six months after discharge.Whether the patient's breast implant displacement was followed and recorded.Results 379 cases were followed up,of which 27 cases(7.12%)had different degrees of displacement,of which 20 cases occurred within one month,7 cases occurred between one month and three months,and three months later There were no new cases of prosthesis displacement;there were a total of 246 cases who wore shaping underwear or bandages(wearing intervention measures),but did not massage or lie on the bed(behavioral intervention measures)as prescribed by the doctor,of which 6 cases were displaced,The displacement rate of the prosthesis was 2.4%;while there were 15 cases without massage,lying on the bed,nor wearing plastic underwear or bandages(only behavioral interventions),3 cases were displaced,and the displacement rate was 20%.The difference between the two groups was statistically significant(20%VS 2.4%,P<0.001).There were a total of 107 cases who wore shaping underwear or bandages as prescribed by the doctor,but had massaged to varying degrees,lying on the bed(wearing only the intervention measures),of which 10 cases had displacement,the displacement rate was 9.3%,and the existing There was a statistically significant difference between the wearing intervention and behavioral intervention groups(9.3%VS 2.4%,P=0.004).There were a total of 11 cases who did not wear plastic underwear or bandages,and had massage and lying on the bed at the same time(without interventions),of which 8 cases were displaced,and the displacement rate was 72.7%,and there were both wearing interventions and behaviors.Compared with the intervention group,the difference was statistically significant(72.7%VS 2.4%,P<0.001).Conclusion Postoperative wearing of shaping underwear or bandage combined with nursing measures of not doing breast massage and lying on the bed in the early stage has a positive effect on preventing the displacement of smooth prosthesis.