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Nursing Care and Causative Analysis of Grade IV Capsular Contracture Following Breast Cancer Expander Implantation
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作者 Rong Chen Nan Zhang Huiting Zhang 《Advances in Breast Cancer Research》 CAS 2024年第1期1-9,共9页
Objective: By observing the treatment and nursing care of a patient with Grade IV capsular contracture following breast cancer expander implantation and subsequent Stage II reconstruction, we aim to analyze the reason... Objective: By observing the treatment and nursing care of a patient with Grade IV capsular contracture following breast cancer expander implantation and subsequent Stage II reconstruction, we aim to analyze the reasons for the formation of capsular contracture after Stage I expander implantation and prevent its recurrence following Stage II reconstruction. Methods: In May 2020, the patient noticed an increase in the size of a breast mass. In August, she underwent AC-THP neoadjuvant chemotherapy, followed by a “right breast-conserving nipple-areolar subglandular excision + right axillary lymph node dissection + expander implantation” surgery in November 2020. Radiation therapy began in January 2021. During radiation therapy, the patient experienced severe breast hardening, distortion, tenderness, and was diagnosed with Grade IV capsular contracture. To relieve the capsular contracture, the patient underwent a “contracted capsule incision and release procedure + removal of the right breast expander + right breast implantation” surgery in July 2021. Postoperatively, measures were taken to prevent incision infection, emphasizing aseptic techniques, ensuring smooth negative pressure drainage, reducing skin flap tension, monitoring skin flap blood supply, actively preventing subcutaneous effusion and hematoma, and applying appropriate compression dressings. Results: The patient was discharged after the removal of the drainage tube. During the postoperative follow-up at 3 and 6 months, there was no recurrence of capsular contracture, and the breast appeared full, upright, and relatively soft. There were no complications such as hematoma, infection, breast implant rupture, breast sagging, or displacement. The patient had a good outcome without additional financial or surgical burdens. Conclusion: The occurrence of Grade IV capsular contracture in the patient is generally related to infection after Stage I expander implantation, improper compression dressing, excessive saline injection causing content infiltration, and radiation therapy. Therefore, it is recommended to enhance the intraoperative and postoperative prophylactic use of antibiotics after Stage I expander implantation. Intermittent saline injection after surgery, with the amount of saline gradually increasing rather than filling all at once, is advisable. This helps the breast tissue gradually adapt to expansion, reducing the risk of capsular contracture. Postoperatively, patients should be instructed to wear pressure garments and breast elastic bandages while intensifying breast monitoring during radiation therapy and increasing postoperative follow-up. 展开更多
关键词 breast Cancer Capsular Contracture Expander implantation
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Breast reconstruction:Review of current autologous and implantbased techniques and long-term oncologic outcome 被引量:1
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作者 Mahdi Malekpour Fatemeh Malekpour Howard Tz-Ho Wang 《World Journal of Clinical Cases》 SCIE 2023年第10期2201-2212,共12页
Implant-based reconstruction is the most common method of breast reconstruction.Autologous breast reconstruction is an indispensable option for breast reconstruction demanding keen microsurgical skills and robust anat... Implant-based reconstruction is the most common method of breast reconstruction.Autologous breast reconstruction is an indispensable option for breast reconstruction demanding keen microsurgical skills and robust anatomical understanding.The reconstructive choice is made by the patient after a discussion with the plastic surgeon covering all the available options.Advantages and disadvantages of each technique along with long-term oncologic outcome are reviewed. 展开更多
关键词 breast Reconstruction MAMMAPLASTY breast implant Autologous Reconstruction Oncologic Outcome breast Neoplasms
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A Totally Absorbable Multilayer PLGA Implant Device Containing Doxorubicin Inhibited Tumor Growth and Metastasis without Systemic Toxicity in Murine Breast Cancer and an Ideal Pharmacological Paradigm for Regional Chemotherapy
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作者 Bennett Elzey Sandra Torregrosa-Allen +2 位作者 Peterson Li Ben Ramsey Matthew Shaw 《Journal of Biosciences and Medicines》 2016年第7期66-81,共17页
We hypothesize that a cylinder implant made of multilayer Poly-lactic-co-glycolic-acid (PLGA) membrane can be a method for controlled and extended drug release. We fashioned a multilayer cylindrical implant termed STI... We hypothesize that a cylinder implant made of multilayer Poly-lactic-co-glycolic-acid (PLGA) membrane can be a method for controlled and extended drug release. We fashioned a multilayer cylindrical implant termed STID100 that released doxorubicin for 3 weeks in an orthotopic 4T1 breast cancer model in Balb/C mice. This implant starts as a thin doxorubicin-embedded PLGA membrane, and is then rolled into a cylinder containing an air gap between the membrane layers. Its controlled sustained release delivered 2× the amount of the intravenous (IV) equivalent of doxorubicin, inhibited the primary tumor, and prevented lung metastasis. Importantly it did not cause weight loss, splenomegaly, or cardiac toxicity vs systemically administrated doxorubicin. This favorable safety profile is further substantiated by the finding of no detectable plasma doxorubicin in multiple time points during the 3-week period, and low tumor doxorubicin concentration. The implant system delivered to the specification of an ideal pharmacological paradigm might offer a better coverage of the local tumor, significantly preventing metastatic spread with less drug toxicity to many vital organs, compared to the traditional pharmacology of IV route. The profile of STID made it an attractive therapeutic alternative in metastatic tumor prevention, pain management and many other diverse clinical scenarios. 展开更多
关键词 PLGA DOXORUBICIN implant Multilayer Membrane METASTASIS Controlled Release Extended Release Polymer Tumor breast Cancer Mice Regional Chemotherapy Pharmacology
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High Risk Breast Cancer Patient with Silicone Breast Implant and Q Inside SafetyTM Micro Transponder
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作者 Michael T. Nelson Sina Meisamy 《Open Journal of Medical Imaging》 2019年第4期52-57,共6页
Motiva Implants&reg;(Establishment Labs Holdings Inc., NY, USA) contains a RFID micro transponder RFID(RT) (RT = registered trademark) known as Q Inside Safety Technology which provides an added safety feature emb... Motiva Implants&reg;(Establishment Labs Holdings Inc., NY, USA) contains a RFID micro transponder RFID(RT) (RT = registered trademark) known as Q Inside Safety Technology which provides an added safety feature embedded in the shell of the Motiva breast implant [1] [2]. Because this RFID micro transponder has Ferric components, a concern over breast MRI imaging susceptibility artifact has arisen. Among breast images, a single high risk breast cancer patient was imaged at our institution (January 2018). All breast imaging modalities were used to determine if this high risk patient had a recurrence of her cancer or any new breast cancer. The MRI showed a susceptibility artifact on the posterior margin of the implant but breast ultrasound showed no abnormalities in the area of the susceptibility artifact. By using high risk screening including Mammography, Tomosynthesis, Breast Ultrasound and Breast MRI, an adequate survey of the high risk patient was completed [3]. Our high risk clinic examined the patient and the imaging results and came to the following conclusion: This patient showed no evidence of recurrent cancer and no new masses were identified. The conclusion was BIRADS 2 benign: normal findings post-mastectomy and implants. Recommendation was for routine high risk screening at yearly interval. 展开更多
关键词 breast MRI Ultrasound MAMMOGRAPHY implantS RADIOFREQUENCY Identification Device [RFID]
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The Effects of Q Inside<sup>TM</sup>Safety Technology Micro Transponder on Routine Breast Implant Imaging
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作者 Sina Meisamy Michael T. Nelson 《Open Journal of Medical Imaging》 2019年第2期19-31,共13页
Objectives: A recent entry into the silicone gel-filled breast implant market from Motiva Implants (Establishment Labs Holdings Inc., NY, USA) contains a radio frequency identification device micro-transponder (RFID-M... Objectives: A recent entry into the silicone gel-filled breast implant market from Motiva Implants (Establishment Labs Holdings Inc., NY, USA) contains a radio frequency identification device micro-transponder (RFID-M), known as the Q Inside Safety Technology, as an added safety feature embedded in the shell of its breast implant. This RFID-M device allows for the rapid unique identification of the implant. Concern for imaging voids due to the presence of the RFID device during MRI screening scans have arisen given its metallic components. Our investigation aims to determine whether the Q Inside Safety Technology RFID-M device in the Motiva Implants Limits the visualization of breast tissue in conventional breast imaging modalities. Methods: Seven patients with Motiva Implants were referred to dedicated diagnostic breast imaging centers for evaluation of their prostheses and surrounding breast parenchyma between January and May 2018. Imaging indications included routine evaluation of implant integrity, evaluation of significant breast symptoms, oncologic follow-up, and breast cancer screenings. Results: Under mammography, the Motiva Implants have a similar contour and mobility to other commonly used implants. The RFID-M is not visible and produces no artifact, allowing for proper visualization and screening of all visualized parenchymal tissues. Under ultrasound, the Motiva Implants are well-visualized in all patients. The RFID-M was not visible in vivo. No related ultrasound artifact was apparent within the lumen or behind the implant as shown in Figure 2(a). Five patients received MRI. The breast parenchyma and axillae were well-visualized in all 5 patients. The RFID-M was found to produce a “butterfly-shaped” susceptibility artifact that projects into the lumen of the breast implant and causes image distortion in some of the surrounding soft tissues and chest wall posterior to the implant. Conclusion: Aside from making its presence evident inside the implant, the Q Inside Safety Technology RFID-M does not interfere with the mammographic or sonographic exam, its results, or any consequent diagnosis made via their analysis. In the same respect using optimized MRI sequences to evaluate patients we were able to obtain satisfactory visualization of breast tissue in patients with the new Motiva Implants, and recommend using optimized study protocols for both early cancer detection and assessment of the implant’s integrity. 展开更多
关键词 breast MRI Ultrasound MAMMOGRAPHY implantS Radio Frequency Identification Device RFID
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Granulomatous Inflammatory Reaction in Breast Silicone Implants
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作者 Tammaro A. Giulianelli V. +5 位作者 NarcisiA. Abruzzese C. Cortesi G. Parisella F.R. Persechino S. Grippaudo F.R. 《Journal of Life Sciences》 2014年第6期558-562,共5页
Introduction: breast implants have been used to correct the size and the form of a breast in post-mastectomy breast reconstruction, for correcting congenital defects and deformities or for purely aesthetic breast aug... Introduction: breast implants have been used to correct the size and the form of a breast in post-mastectomy breast reconstruction, for correcting congenital defects and deformities or for purely aesthetic breast augmentation. Silicone breast implants were introduced in the 1960s. They are non without complications, like rupture is or silicone gel bleeding. Materials and methods: the authors present the case of 50 patients, aged 45-55, who presented to our attention after 15 (+ 5) years of the application of silicone breast implant for the appearance of lumps under the skin in the armpit area. These were palpable, painless except on palpation. The patients reported burning in the affected area, but no other symptoms. Results: considering the presence in each of them of silicone implants, and assuming a possible allergic basis, the authors performed a patch test series S1DAPA produced by F.I.R.M.A Spa, Firenze, ultrasound and MR and blood tests. In all patients the allergy test (patch test) were negative, ultrasound and MR have shown that no hearing was damaged or broken. Blood test showed no abnormalities. Discussion: comparing the authors' study with other similar works in the literature, they noted that the reported cases of hypersensitivity type 4 silicone prosthesis was not only initially accompanied by specific symptoms such as urticaria and blistering, but mostly it was found to be a net positive patch test. The absence of urticaria, the low values of lgE and total negativity of patch test confirmed the purely inflammatory nature of the lesions in our patients. 展开更多
关键词 Silicone breast implant INFLAMMATION siliconoma patch test.
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Progress in Implant-Based Breast Reconstruction:What Do We Know?
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作者 Xueqing HU Cheng HUANG 《Chinese Journal of Plastic and Reconstructive Surgery》 2021年第2期103-108,共6页
Breast cancer is the most common malignancy and the most frequently diagnosed cancer in women worldwide.In China,the incidence rate of breast cancer among women has been showing an upward trend and is higher in urban ... Breast cancer is the most common malignancy and the most frequently diagnosed cancer in women worldwide.In China,the incidence rate of breast cancer among women has been showing an upward trend and is higher in urban areas.Decades of clinical research have made considerable progress,which is attributable to improved mastectomy and maintenance of a well-perfused skin flap after mastectomy.An in-depth insight into the nature of breast cancer will contribute to reduced overall mortality and prolonged survival.In China,there is an increasing awareness of the importance of breast reconstruction in improving quality of life(QoL)and life expectancy.There has been progress in breast reconstruction surgical procedures due to demand from women.Clinicians should be aware that breast reconstruction is not only a medical problem but also a surgical problem.In the following sections,we present the epitome of advances in implant-based breast reconstruction. 展开更多
关键词 breast reconstruction implant Acellular dermal matrix EXPANDER
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Single Abscess as the First Manifestation of Breast ALK-Positive Anaplastic Large Cell Lymphoma in Pregnancy Without Breast Implants:A Case Report
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作者 Da-Ping Song Wen-Yan Zhang 《Journal of Clinical and Nursing Research》 2022年第2期36-39,共4页
Primary lymphoma involving the breast accounts for only 0.04-0.5%of malignant breast tumors,constituting 1-2%of all non-Hodgkin lymphomas(NHL).Here,we report a case of breast ALK-positive ALCL arising in a 21-year-old... Primary lymphoma involving the breast accounts for only 0.04-0.5%of malignant breast tumors,constituting 1-2%of all non-Hodgkin lymphomas(NHL).Here,we report a case of breast ALK-positive ALCL arising in a 21-year-old woman in pregnancy with single abscess as the first clinical manifestation. 展开更多
关键词 ALK-positive anaplastic large cell lymphoma in pregnancy breast implants
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Lessons Learned from Three Different Acellular Dermal Matrices in Direct-to-Implant Breast Reconstruction
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作者 Claas Spengler Roland Mett +2 位作者 Frank Masberg Peter M. Vogt Tobias R. Mett 《Modern Plastic Surgery》 2021年第1期22-35,共14页
The aim of the study was to show significant differences regarding postoperative complications and outcomes using three different Acellular Dermal Matrices (ADM), namely Epiflex<span style="white-space:nowrap;... The aim of the study was to show significant differences regarding postoperative complications and outcomes using three different Acellular Dermal Matrices (ADM), namely Epiflex<span style="white-space:nowrap;"><span style="white-space:nowrap;"><sup>&#174;</sup></span></span>, Strattice<span style="white-space:nowrap;"><span style="white-space:nowrap;"><sup>&#174;</sup></span></span> and Braxon<span style="white-space:nowrap;"><span style="white-space:nowrap;"><sup>&#174;</sup></span></span>, in immediate implant-based subpectoral breast reconstruction cases. <strong>Background:</strong> The use of Acellular Dermal Matrices for implant-based breast reconstruction cases continues to evolve. There is a wide variety of products which differ significantly in their biological features. It remains unclear if and how these differences manifest in clinical practice. <strong>Methods:</strong> 82 cases of primary breast reconstruction in the Department of Plastic and Aesthetic Surgery of HELIOS Clinics Schwerin, Germany between 2010 and 2018 were analyzed. 25 patients received Strattice<span style="white-space:nowrap;"><span style="white-space:nowrap;"><sup>&#174;</sup></span></span> acellular dermal matrix (SADM), 22 cases Epiflex<span style="white-space:nowrap;"><span style="white-space:nowrap;"><sup>&#174;</sup></span></span> acellular dermal matrix (EADM) and the remaining 35 cases Braxon<span style="white-space:nowrap;"><span style="white-space:nowrap;"><sup>&#174;</sup></span></span> acellular dermal matrix (BADM). The mean follow-up was 1.8 years. Cases were analyzed regarding minor or major complications and rate of capsular contracture grade III or IV (Baker Classification). <strong>Results:</strong> The overall complication rate was 34.1% for all groups (SADM = 40%, EADM = 50%, BADM = 20%, p-value = 0.051). Of all cases, 6 patients underwent implant exchange or secondary autologous reconstruction due to capsular contracture (7.3%). The mean time between revision due to capsular contracture and reconstruction was 35.8 ± 14.4 months. 50% of patients, who developed capsular contracture, received postoperative radiation. Mean hospitalization time was 8.2 ± 3 days (SADM = 8 ± 3.2 days, EADM = 10 ± 2.8 days, BADM = 6 ± 1.3 days). There were no significant differences between all three groups for demographics, overall complication rate or capsular contracture. However, patients receiving Braxon<span style="white-space:nowrap;"><span style="white-space:nowrap;"><sup>&#174;</sup></span></span> matrix showed significantly fewer minor complications (p-value = 0.01). Moreover, patients receiving Braxon<span style="white-space:nowrap;"><span style="white-space:nowrap;"><sup>&#174;</sup></span></span> ADM showed a significantly lower time of hospitalization (p < 0.001). <strong>Conclusion:</strong> No significant differences regarding the overall complication rate were found between the three groups. Different biological features of ADM showed a weak influence on overall results. However, patients receiving Braxon<span style="white-space:nowrap;"><span style="white-space:nowrap;"><sup>&#174;</sup></span></span> ADM showed significantly lower minor complication rates and hospitalization time. In addition, these matrices showed a trend towards lower capsular contracture rates. The low rate of capsular contracture hints at possible advantages of ADM-use in direct-to-implant cases. 展开更多
关键词 breast Reconstruction Acellular Dermal Matrix ADM Direct-to-implant DTI Immediate breast Reconstruction IBR breast Cancer Skin Sparing Mastectomy EPIFLEX Strattice BRAXON
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乳腺癌保乳术后应用3D技术填充瘤腔进行适形放疗的临床研究
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作者 李晓军 王和煦 +3 位作者 张佳 王绩钊 朱财林 崔晓海 《中国临床保健杂志》 CAS 2024年第1期102-105,共4页
目的探究乳腺癌保乳术后应用3D技术填充瘤腔进行适形放疗的靶区剂量、不良反应及美容度。方法选择2021年1月至2022年12月西安交通大学第一附属医院收治的48例乳腺癌患者,按照手术不同分为3D技术填充瘤腔组(24例)及对照组(24例)。全部患... 目的探究乳腺癌保乳术后应用3D技术填充瘤腔进行适形放疗的靶区剂量、不良反应及美容度。方法选择2021年1月至2022年12月西安交通大学第一附属医院收治的48例乳腺癌患者,按照手术不同分为3D技术填充瘤腔组(24例)及对照组(24例)。全部患者均开展乳腺癌根治手术治疗,仅保乳方式不同,术后实施强度调控适形放射治疗计划下的加速部分乳腺照射。结果应用3D技术填充瘤腔保乳术后放疗的适形度指数及均匀性指数均明显高于常规保乳术后放疗(P<0.05)。3D技术填充瘤腔保乳术后放疗的肺及心脏危及器官剂量(平均剂量),肺的V 5、V 10、V 20、V 30、V 40及V 50均显著低于常规保乳术后放疗组(P<0.05)。2组患者的皮肤损伤、心律失常、骨髓抑制及消化道反应发生率差异无统计学意义。3D技术填充瘤腔保乳术后组患者的美容度要显著优于常规保乳术后患者(P<0.05)。结论乳腺癌保乳术后应用3D技术填充瘤腔显著增强乳腺的美容度,且不影响放疗的安全及有效性。 展开更多
关键词 乳腺肿瘤 乳房切除术 区段 放射疗法 适形 乳房植入 化放疗
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即刻植入物乳房重建失败风险列线图模型的构建与验证
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作者 竺美珍 毛洁飞 +1 位作者 王跃珍 方军 《浙江医学》 CAS 2024年第14期1501-1506,共6页
目的评估即刻植入物乳房重建(IBR)失败的风险因素,构建列线图模型并验证。方法回顾性分析2016年1月至2020年12月在浙江省肿瘤医院行即刻IBR手术的241例患者,按7∶3随机分为训练组(169例)和验证组(72例)。训练组依据重建失败(RF)是否发生... 目的评估即刻植入物乳房重建(IBR)失败的风险因素,构建列线图模型并验证。方法回顾性分析2016年1月至2020年12月在浙江省肿瘤医院行即刻IBR手术的241例患者,按7∶3随机分为训练组(169例)和验证组(72例)。训练组依据重建失败(RF)是否发生,分为RF组(10例)和非RF组(159例),比较并分析两组临床资料,采用多因素logistic回归分析影响RF的独立风险因素,建立列线图模型;绘制ROC曲线,评估模型预测即刻IBR术后RF的效能;绘制校准曲线,评估即刻IBR术后发生RF的一致性。结果高BMI、植入物体积>86.30%、辅助化疗(ACT)是即刻IBR术后RF的独立风险因素(均P<0.05)。基于BMI、淋巴结手术方式、植入物体积、补片使用和ACT这5个变量构建列线图模型,模型预测训练组即刻IBR术后RF的AUC为0.920,预测验证组的AUC为0.930;模型的Brier评分为0.040。校准曲线显示,实际观察和模型预测之间存在较好的一致性。结论列线图模型能够较好预测即刻IBR术后RF的风险,有助于指导临床早期干预RF。 展开更多
关键词 乳房植入物 乳房重建 重建失败 列线图
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乳腺癌术后Ⅰ期乳房再造中腔镜与开放假体重建的单中心回顾性研究 被引量:1
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作者 任黎蕾 赵小波 +3 位作者 高砚春 侯令密 林帅 黄红莉 《西部医学》 2024年第5期707-712,共6页
目的比较腔镜下乳房切除术后即刻植入物重建与开放手术的并发症与满意度相关分析。方法纳入2019年1月—2022年5月本院收治早期乳腺癌接受术后乳房即刻重建的患者96例,分为腔镜手术组36例,开放手术组60例。采用行非参数检验、Mann-Whitne... 目的比较腔镜下乳房切除术后即刻植入物重建与开放手术的并发症与满意度相关分析。方法纳入2019年1月—2022年5月本院收治早期乳腺癌接受术后乳房即刻重建的患者96例,分为腔镜手术组36例,开放手术组60例。采用行非参数检验、Mann-Whitney U检验、Logistic回归分析比较两组患者年龄、肿瘤位置、手术方式、组织学分级、新辅助化疗、辅助化疗、放疗、是否保留乳头乳晕、有无并发症、是否局部复发及满意度相关因素。结果两组患者年龄经非参数检验差异无统计学意义(P>0.05)。组织学分级、肿瘤位置、新辅助化疗、是否保留乳头乳晕的构成比存在显著差异(P<0.05),手术方式、辅助化疗、辅助放疗、术后并发症与局部复发在不同组别之间经构成比差异无统计学意义(P>0.05)。在单因素Logistic回归中行前哨淋巴结活检、腋窝淋巴结清扫术、新辅助化疗治疗、辅助放疗治疗、保留乳头乳晕与即刻乳房重建术后并发症的发生具有相关性(P<0.05)。多因素分析提示,腋窝淋巴结清扫、假体体积、高血压、保留乳头乳晕是并发症发生率的相对独立的影响因素。结论单孔充气法腔镜辅助乳房皮下切除假体植入Ⅰ期乳房重建对于符合条件的乳腺癌安全可行,具有创口小、并发症发生率低及相关风险可控,获得较好的根治效果和乳房形态,患者生活质量和满意度高,可在临床推广应用。 展开更多
关键词 乳腺癌 乳房植入物 腔镜乳房切除手术 术后并发症 满意度
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基于扎根理论的心理护理教育在乳腺癌化疗患者植入式输液港管理中的应用 被引量:3
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作者 苏萱 吴小香 乔敏敏 《齐鲁护理杂志》 2024年第3期25-28,共4页
目的:探讨基于扎根理论的心理护理教育在乳腺癌化疗患者植入式输液港管理中的应用效果。方法:选取2019年1月1日~2022年1月31日收治的100例乳腺癌化疗患者为研究对象,均植入植入式输液港,随机分为观察组和对照组各50例,对照组采用常规护... 目的:探讨基于扎根理论的心理护理教育在乳腺癌化疗患者植入式输液港管理中的应用效果。方法:选取2019年1月1日~2022年1月31日收治的100例乳腺癌化疗患者为研究对象,均植入植入式输液港,随机分为观察组和对照组各50例,对照组采用常规护理,观察组采用基于扎根理论的心理护理教育;比较两组干预前后心理状态[采用症状自评量表(SCL-90)]、生活质量[采用乳腺癌患者生命质量测定量表(FACT-B)],并发症发生情况,护理满意度。结果:干预后,两组SCL-90评分低于干预前(P<0.05),且观察组低于对照组(P<0.05,P<0.01);干预后,两组FACT-B评分高于干预前(P<0.05),且观察组高于对照组(P<0.01);观察组并发症发生率低于对照组(P<0.05),护理满意度高于对照组(P<0.05)。结论:将基于扎根理论的心理护理教育用于乳腺癌化疗患者植入式输液港管理中,可改善患者的心理状态,提高其生活质量、护理满意度,减少并发症的发生。 展开更多
关键词 扎根理论 心理护理 乳腺癌 植入式输液港
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三维扫描成像在单侧假体乳房重建术前评估中的应用 被引量:1
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作者 林涛 王喜梅 +2 位作者 李志斌 谢百慧 闫成祥 《中国美容医学》 CAS 2024年第2期34-37,共4页
目的:探讨三维扫描成像在单侧假体乳房重建术前评估中的应用价值。方法:回顾性分析2018年1月-2021年9月于笔者科室行假体乳房重建术的15例单侧乳房萎缩或缺陷患者临床资料,所有患者术前均行三维扫描成像,得到术前乳房容量差异评估(Preop... 目的:探讨三维扫描成像在单侧假体乳房重建术前评估中的应用价值。方法:回顾性分析2018年1月-2021年9月于笔者科室行假体乳房重建术的15例单侧乳房萎缩或缺陷患者临床资料,所有患者术前均行三维扫描成像,得到术前乳房容量差异评估(Preoperative assessment of breast volume difference,PABVD),依据该结果得出最接近的乳房假体容量,记为预计假体容量(Predicted prosthesis volume,PPV);术中剥离腔隙后,将圆形扩张器置入腔隙,注水评估容量差异,即为术中乳房容量差异评估(Intraoperative assessment of breast volume difference,IABVD),以IABVD参考选择最为相近的假体容量,记为实际假体容量(Actual prosthesis volume,APV),置入假体后,重建乳房下皱襞。术后给予止痛泵镇痛、抗瘢痕综合治疗。统计学分析数据,并对患者术后并发症、医患沟通满意度及手术效果满意度进行随访。结果:PABVD为(181.6±39.0)ml,IABVD为(178.6±36.4)ml,两者比较差异无统计学意义(P>0.05),PPV与APV吻合率达93.33%(14/15),PABVD与APV有较强关联性(P<0.05)。术后随访3~6个月,再造乳房形态自然、挺拔,双侧较对称,切口瘢痕位于新的乳房下皱襞处,术后均无明显瘢痕增生、包膜挛缩、感染等并发症,医患沟通良好,患者对手术效果满意。结论:三维扫描成像能够精确获取乳房的外在轮廓,并在术前对乳房容量差异进行可靠评估,有利于医患之间良好沟通,同时对于手术规划及预选假体有重要参考价值。 展开更多
关键词 三维扫描 乳房重建 乳房容量 三维成像 硅胶假体
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乳腺癌植入式静脉输液港患者导管相关性血栓形成危险因素的Meta分析
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作者 徐芸 盛丽娟 +2 位作者 张海燕 裴静 江守伟 《军事护理》 CSCD 北大核心 2024年第10期9-12,共4页
目的 分析乳腺癌植入式静脉输液港患者导管相关性血栓形成的危险因素,为避免发生导管相关性血栓提供参考。方法 计算机检索中国知网、万方、维普、中国生物医学文献服务系统、PubMed、Web of Science、Embase、Cochrane Library等数据... 目的 分析乳腺癌植入式静脉输液港患者导管相关性血栓形成的危险因素,为避免发生导管相关性血栓提供参考。方法 计算机检索中国知网、万方、维普、中国生物医学文献服务系统、PubMed、Web of Science、Embase、Cochrane Library等数据库中关于乳腺癌植入式静脉输液港患者导管相关性血栓形成危险因素的病例对照研究和队列研究,检索时限为建库至2024年1月,采用RevMan5.3软件进行Meta分析。结果 共纳入19篇文献,9938例乳腺癌患者。年龄≥60岁(OR=0.44,P=0.005)、体质量指数>24 kg/m2(OR=1.85,P=0.001)、硅胶导管材质(OR=0.75,P=0.040)、左侧置管(OR=1.23,P=0.040)、上臂输液港植入(OR=0.23,P=0.010)、蒽环类与紫杉类联合化疗方案(OR=1.95,P=0.030)、肿瘤临床分期Ⅲ~Ⅳ期(OR=0.53,P<0.001)、静脉血栓史(OR=3.24,P=0.030)、高凝状态(OR=2.43,P<0.001)、高血压史(OR=1.84,P=0.001)是乳腺癌植入式静脉输液港患者导管相关性血栓形成的危险因素。结论 医护人员应加强高危乳腺癌患者的管理,针对上述危险因素提前采取措施,以降低导管相关性血栓的发生率,提高其生活质量。 展开更多
关键词 乳腺肿瘤 植入式静脉输液港 导管相关性血栓 危险因素 META分析 护理
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预防乳腺癌病人上臂植入式输液港感染的循证实践
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作者 王慧欣 黄丽梅 +7 位作者 付攸缘 刘杨晨 赵慧慧 吴加花 周春姣 魏琳 林美珍 张广清 《循证护理》 2024年第19期3474-3480,共7页
目的:开展预防乳腺癌病人上臂植入式输液港感染的循证实践,寻找最佳证据并应用于临床,以降低感染发生率。方法:遵循Joanna Briggs Institute(JBI)临床证据实践应用模式,包括基线审查、证据转化并应用于临床实施变革、证据应用后审查3个... 目的:开展预防乳腺癌病人上臂植入式输液港感染的循证实践,寻找最佳证据并应用于临床,以降低感染发生率。方法:遵循Joanna Briggs Institute(JBI)临床证据实践应用模式,包括基线审查、证据转化并应用于临床实施变革、证据应用后审查3个阶段。检索中英文数据库,获取预防上臂植入式输液港感染最佳策略的证据,提取出21条证据,根据FAME结构采纳其中16条证据,转化为16条审查指标,应用于临床实践并评价其效果。结果:证据应用后,病人上臂植入式输液港感染发生率低于证据应用前(P<0.05),护士及病人上臂植入式输液港知识调查问卷得分高于证据应用前(P<0.05),16条审查指标,除指标3、6、11~15执行率在证据应用前已达100%,其余9项审查指标执行情况均优于证据应用前(P<0.05)。结论:预防上臂植入式输液港感染的循证实践可降低感染发生率,规范上臂植入式输液港的培训和管理,提高护士专业知识水平,提高病人输液港维护知识掌握程度。 展开更多
关键词 乳腺癌 上臂植入式输液港感染 预防 循证实践 循证护理
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乳腺癌患者延长输液港无损伤针使用时间的效果研究
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作者 侯健文 胡泽盈 +2 位作者 章敏 于丽 谢玲女 《中国现代医生》 2024年第12期64-66,90,共4页
目的探讨乳腺癌患者延长输液港无损伤针使用时间的可行性和安全性。方法采用便利取样法选取2022年6月至12月浙江省肿瘤医院100例植入胸壁输液港的乳腺癌患者,根据拔除无损伤针时间按随机数字表法将患者均分为7d组和8d组。比较两组患者... 目的探讨乳腺癌患者延长输液港无损伤针使用时间的可行性和安全性。方法采用便利取样法选取2022年6月至12月浙江省肿瘤医院100例植入胸壁输液港的乳腺癌患者,根据拔除无损伤针时间按随机数字表法将患者均分为7d组和8d组。比较两组患者的导管功能、导管相关并发症、舒适度及成本。结果两组患者输液港导管回抽均有回血且冲管顺利;7d组1例和8d组2例患者出现局部皮肤过敏;7d组患者舒适度测评中舒适占比86%,8d组患者舒适占比90%,差异均无统计学意义(P>0.05);7d组人均输液港维护费用高于8d组,差异有统计学意义(P<0.05)。结论在一定情况下经护士评估后可适当延长乳腺癌患者输液港无损伤针使用时间,以提高工作效率,减少费用。 展开更多
关键词 乳腺癌 输液港 无损伤针 成本分析
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品管圈模式在提高乳腺癌根治术后患者义乳知识中的应用
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作者 邓雅丽 胡美霞 《中国医药指南》 2024年第9期22-24,共3页
目的提高乳腺癌根治术后患者对义乳知识的知晓率及佩戴率,改善其生活质量,规范科室义乳的宣教,提升专科护理内涵。方法根据品管圈模式(QCC)管理的十大步骤,收集改善措施实施前的2021年12月1日至2022年1月15日乳腺癌根治术后患者对义乳... 目的提高乳腺癌根治术后患者对义乳知识的知晓率及佩戴率,改善其生活质量,规范科室义乳的宣教,提升专科护理内涵。方法根据品管圈模式(QCC)管理的十大步骤,收集改善措施实施前的2021年12月1日至2022年1月15日乳腺癌根治术后患者对义乳的知晓率、佩戴率及原因,用鱼骨图、柏拉图等方法分析导致义乳知晓率低、佩戴率低的主要真因;收集导入改善措施后2022年5月1日至2022年6月15日义乳知晓率及佩戴率情况,分析对应的改进措施,评价措施的有效性。患者在出院时完成义乳知晓率调查问卷。结果应用QCC管理模式后乳腺癌根治术后患者义乳知识的知晓率由47.82%提高到86.95%,义乳佩戴率由31.81%提高到59.09%。结论QCC管理模式能提高乳腺癌根治术后患者义乳知识的知晓率及佩戴率,改善护理服务质量,提升患者满意度。 展开更多
关键词 品管圈(QCC) 管理模式 义乳知晓率 义乳佩戴率
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乳腺癌1期胸肌后假体重建术后短期内发生皮瓣坏死的影响因素
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作者 吕太辉 迟江瑞 +1 位作者 许一佳 李林 《河南外科学杂志》 2024年第5期4-7,共4页
目的分析乳腺癌患者行1期胸肌后假体重建术后短期内皮瓣坏死的影响因素。方法回顾性分析2018-01—2023-05于郑州大学第一附属医院乳腺外科行乳腺癌1期胸肌后假体重建的264例乳腺癌患者的临床资料,使用t检验和卡方检验分析皮瓣坏死的影... 目的分析乳腺癌患者行1期胸肌后假体重建术后短期内皮瓣坏死的影响因素。方法回顾性分析2018-01—2023-05于郑州大学第一附属医院乳腺外科行乳腺癌1期胸肌后假体重建的264例乳腺癌患者的临床资料,使用t检验和卡方检验分析皮瓣坏死的影响因素,并通过Logistic回归模型进行多因素分析,确定皮瓣坏死的危险因素。结果共有264例乳腺癌患者进行了268台乳房重建手术。经过单因素分析显示,足够的皮瓣厚度和下皱襞切口分别被证明是皮瓣坏死的保护因素(P<0.05)。Logistic回归分析显示,皮瓣厚度和切口类型是皮瓣坏死的独立危险因素(P<0.05)。结论皮瓣厚度和手术切口的选择对乳腺癌1期假体重建后的皮瓣坏死具有显著影响。保留足够的皮瓣厚度,选择下皱襞切口,不仅更加安全,而且更符合美学需求。 展开更多
关键词 乳腺癌 植入物 乳房重建 皮瓣坏死
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两种不同入路行双平面假体隆乳术临床疗效对比研究
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作者 董远 冯跃庆 《中国卫生标准管理》 2024年第1期27-30,共4页
目的探讨不同入路行双平面假体隆乳术的效果。方法回顾性分析2020年1月—2023年1月新乡市中心医院收治的629例行双平面假体隆乳术患者的临床资料,按其手术入路的不同将其分为2组,其中经乳晕入路行手术的329例患者纳入对照组,经腋窝入路... 目的探讨不同入路行双平面假体隆乳术的效果。方法回顾性分析2020年1月—2023年1月新乡市中心医院收治的629例行双平面假体隆乳术患者的临床资料,按其手术入路的不同将其分为2组,其中经乳晕入路行手术的329例患者纳入对照组,经腋窝入路行手术的300例患者纳入观察组,术后均随访6个月。对比2组手术相关指标、乳房形态变化、隆胸效果、并发症。结果观察组切口愈合时间[(7.30±1.25)d]短于对照组[(9.21±1.69)d],并发症发生率(1.67%)低于对照组(4.86%),差异有统计学意义(P<0.05)。2组术中出血量、手术时间、住院时间、术后数字评分法(numeric rating scale,NRS)评分、隆胸效果相比,差异无统计学意义(P>0.05)。术前、术后2组乳头-乳房下皱襞的经皮距离(nipple to inframammaryfold,N-IMF)、胸骨切迹-乳头距离(sternal notch to nipple,S-N)、乳头-正中线距离(nipple to midline,N-M)、乳房总体积相比,差异无统计学意义(P>0.05)。结论经乳晕入路、经腋窝入路行双平面假体隆乳术均能够取得优良的隆胸效果,但经腋窝入路行手术更能够促进切口愈合,降低并发症发生率。文章的研究结果为临床后期选择双平面假体隆乳术的入路提供了借鉴内容,具有一定的运用价值。 展开更多
关键词 双平面假体隆乳术 并发症 腋窝入路 乳晕入路 术中出血量 乳房形态
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