【作者】 王丹丹；

【导师】 刘林嶓；

【作者基本信息】 郑州大学 ， 外科学， 2013， 硕士

【摘要】 目的通过与乳腺癌改良根治术比较评价乳腺癌改良根治术后即刻假体植入进行乳房重建方法对患者预后及生活质量的影响。材料与方法研究组为20例行女性乳腺癌改良根治术后即刻假体置入进行乳房重建术的患者。对照组为30例女性单纯行乳腺癌改良根治术的患者。术后6个月均采用Harris标准和综合满意度评价重建乳房美容效果,并通过中文版乳腺癌治疗功能评价(FACT-B)量表评价患者生活质量。对2组患者随访2年,评价乳腺癌的复发与转移情况。结果(1)2组患者的年龄、肿瘤大小、肿瘤分级在统计学上无显著差异(P<0.05)。(2)重建组20例患者乳房重建均获成功,术后6个月Harris标准评价结果表明乳腺癌改良根治术后即刻假体置入进行乳房重建术组患者中优12例、良5例、一般3例、差0例。术后6个月对患者综合满意度的调查分别为很好37.5%,较好47.5%,一般12.5%,差2.5%,非常差0%。术后6个月重建组患者的各项生活质量评分明显高于对照组。2组比较差异有统计学意义。(3)随访2年2组均未见肿瘤复发与转移。结论乳腺癌改良根治术后即刻假体置入具有操作简单迅速、效果良好、安全性能高及恢复快等优点,能在改善乳房形态的基础上减轻患者因乳房缺失、形态毁损造成的心理障碍,提高患者的生活质量,值得临床推广。更多还原

【Abstract】 ObjectiveTo dicuss the the influence of immediate prosthesis implantation for breast reconstruction after modified radical mastectomy on the prognosis and quality of life of patients by comparing with patients underwent modified radical mastectomy.Materials and methodsThe study group contain20femal patients with breast cancer underwent immediate prosthesis implantation for breast reconstruction after modified radical mastectomy. The control group contain30female patients underwent only modified radical mastectomy. The drainage volume changes were monitored in the operative process. Harris criteria and composite satisfaction was used to evaluate the reconstruction cosmetic effect for patients in study group6months after operation. Chinese version of the breast cancer treatment function evaluation (FACT-B) scale was used for the quality of life of the patients.2-year follow-up was used for the evaluation of breast cancer recurrence and metastasis of2groups of patients.Results1. There are no difference between the2groups of the patients in age, tumor location, tumor size, tumor grade difference (P＞0.05).2. The breast reconstruction operation was successfully achieved in the20patients of reconstruction group. The evalution with Harris criteria at six months after surgery showed that the prognosis of patients underwent immediate prosthesis implantation for breast reconstruction after modified radical mastectomy were good:12cases feel excellent,5cases feel good,3cases are generally and0case feel poor. The evalution with composite satisfaction at6months after operation was satisfactory:37.5%cases are excellent,47.5%cases are preferably,12.5%cases are average,2.5%cases are bad,0%cases are very bad. The patient’s life quality scores are higher in reconstruction group than control group at6months after operation. There is significant difference between the2groups (P<0.05).3.2-year follow-up results showed that there are no tumor recurrence and metastasis in all the patients.ConclusionThe method of the immediate prosthesis implantation for breast reconstruction after modified radical mastectomy has the merits of simple and rapid operation, favorable effect, safe and rapid recovery. It can alleviate the psychological barrier of the patients for breast deficiency and derogative form by improving breast form. And it can improve patients’life quality. So it is worthy for being widely used in treatment.更多还原