假体联合补片即刻乳房再造手术并发症的预防与治疗  

Prevention and treatment for postoperative complications of implant-based breast reconstruction with meshe

作　　者：张勇 陈诚 杨燕文 陆南杭 冯自豪 朱玮 亓发芝 ZHANG Yong;CHEN Cheng;YANG Yan-wen;LU Nan-hang;FENG Zi-hao;ZHU Wei;QI Fa-zhi(Department of Plastic and Reconstructive Surgery,Zhongshan Hopspital,Fudan University,Shanghai City,200032,China)

机构地区：[1]复旦大学附属中山医院整形外科,上海200032 [2]复旦大学附属中山医院乳腺外科,上海200032

出　　处：《中国医疗美容》2022年第11期4-7,共4页China Medical Cosmetology

摘　　要：目的研究假体联合补片乳房再造术后常见并发症的预防及治疗。方法回顾性分析从2016年1月至2019年12月我院整形外科与乳腺外科合作开展乳腺癌术后即刻假体乳房再造患者的临床资料。根据是否联合补片及补片材料来源分为三组,单纯假体再造组,假体联合生物补片组,假体联合人工补片组。收集术后伤口引流及引流管拔管时间,术后各类并发症信息。比较不同组间差别。结果共收治患者116例,121侧假体乳房再造患者。假体联合补片组的伤口引流总量及拔管时间均有明显上升。假体联合补片组发生血肿血清肿的风险较单纯假体再造组更高,发生假体感染及外露的情况也比单纯应用假体组发生率高。但联合应用补片假体乳房再造组远期发生包膜挛缩的风险比单纯假体乳房再造的患者更低。远期再造乳房形态满意度更高。结论假体联合补片乳房再造较单纯假体乳房再造,术后引流量及引流管放置时间均有所增加,术后部分短期并发症有所上升,远期并发症如包膜挛缩发生率更低,乳房再造形态满意度更高。Objective To study the complications after implant based breast reconstruction combined with mesh.Methods We retrospectively analyzed the clinical data of patients with immediate breast reconstruction after breast cancer surgery in our hospital.The patients were divided into three groups according to whether the mesh was used and the sort of the mesh material.The postoperative wound drainage and the time of drainage tube removed,and various postoperative complications were collected.Results A total of 116 patients including 121 reconstructed breasts were treated.The volume and time of wound drainage were significantly increased in the group of implant combined with the mesh.The risk of hematoma and seroma in the implant combined with mesh group was higher than that in the group with implant only,and the incidence of implant infection and exposure was also higher than that in the implant group.However,the risk of long-term capsular contracture was lower in the group of implant based breast reconstruction combined with mesh.Conclusions Breast reconstruction with implant combined with mesh is compared with breast reconstruction with implant only,and the postoperative drainage volume and time are increased,some short-term complications after surgery are increased,but the incidence of long-term complications such as capsular contracture is lower.

关 键 词：乳房再造 术后并发症 乳房假体补片 

分 类 号：R655.8[医药卫生—外科学]