王志刚　雷泽华　乔正荣　李远平

[摘要] 目的 比较乳腺癌患者术中即刻乳房重建与术后再造的效果。 方法 选取2014年1月～2017年2月乐山市人民医院、峨眉山市佛光医院和重庆市第八人民医院乳腺癌根治术女性患者62例，按照简单数字列表法分为观察组和对照组，每组各31例。观察组在乳腺癌改良根治术中行即刻乳房重建；对照组在根治术后行延期乳房再造。观察两组患者手术时间、住院时间、术中出血量及并发症发生率。术后随访1年，观察两组患者治疗优良率、治疗满意度、术后并发症、手术满意度、术后健康调查简表（SF-36）生活质量评分。 结果 两组患者手术时间、住院时间、术中出血量、并发症发生率比较，差异无统计学意义（P > 0.05）；术后随访1年，观察组治疗优良率、手术满意度、SF-36生活质量评分均高于对照组，差异有统计学意义（P < 0.05）。两组术后并发症比较，差异无统计学意义（P > 0.05）。 结论 即刻乳房重建术可提高乳腺癌根治术后患者治疗满意度，改善患者生活质量，不增加手术并发症，可在临床推廣应用。

[关键词] 乳腺癌；即刻乳房重建；改良根治术；延期乳房再造；生活质量

[中图分类号] R655.8 [文献标识码] A [文章编号] 1673-7210（2018）09（b）-0081-04

[Abstract] Objective To compare the effect of immediate breast reconstruction and postoperative reconstruction in breast cancer patients. Methods From January 2014 to February 2017， in Leshan People's Hospital， Emeishan Foguang Hospital and Chongqing Eighth People′s Hospital， 62 female patients with radical mastectomy were selected， according to the list of simple digital method， they were divided into observation group and control group， with 31 cases in each group. In the observation group， the reconstruction of breast cancer was performed immediately. The control group delayed breast reconstruction after radical surgery. The operation time， length of hospitalization， intraoperative blood loss and complication rate were observed in the two groups. After 1 year follow-up， the treat excellent rate， postoperative complications， postoperative SF-36 life quality score in two groups were observed. Results There was no statistically significant difference between the two groups in operation time， length of hospital stay， intraoperative blood loss and complication rate （P > 0.05）. After 1 year of postoperative follow-up， the treatment excellent rate， surgical satisfaction rate， SF-36 life quality score in the observation group were higher than the control group， the differences were statistically significant （P < 0.05）. The postoperative complications in the two groups was compared， the difference was not statistically significant （P > 0.05）. Conclusion Immediate breast reconstruction can improve the treatment satisfaction of patients after radical mastectomy， improve the quality of life of patients， and not increase surgical complications， it can be widely used in clinical.

[Key words] Breast cancer； Immediate breast reconstruction； Modified radical operation； Delayed breast reconstruction； Living quality

乳腺癌已成为全球威胁女性健康的常见恶性肿瘤，可能与遗传有关。女性患者乳腺癌比例高达99%[1]，随着循证医学证据的不断积累，乳腺癌手术范围由最大可耐受治疗转变为最小有效治疗的趋势已达成共识[2]。由于乳腺癌低龄化逐年增加[3]，女性患者的乳房美观和乳房再造要求越来越高[4]。传统观念认为为了保证根治术的效果，需延迟乳房再造[5]，但是术后乳房美观度较差。经……