假体隆乳术后发生包膜挛缩的多因素分析  

Multivariate analysis of capsular contracture after breast augmentation with prosthesis

作　　者：王晓朋 汪芸 荆冲 WANG Xiaopeng;WANG Yun;JING Chong(Department of Plastic Surgery,Changsha Yamei Medical Plastic Hospital,Changsha 410000,China)

机构地区：[1]长沙雅美医疗美容医院,湖南省长沙市410000

出　　处：《组织工程与重建外科》2024年第2期199-204,共6页Journal of Tissue Engineering and Reconstructive Surgery

摘　　要：目的研究假体隆乳术后包膜挛缩发生的相关因素。方法采用回顾性对照研究的方法,对2019年4月到2020年1月收治的227例硅凝胶假体隆乳手术患者的临床资料进行分析,依据是否发生包膜挛缩分为包膜挛缩组和对照组。随访24个月,比较两组患者的年龄、BMI、吸烟史、哺乳史、手术入路、假体品牌及表面性状、假体是否选择过大、是否使用内窥镜、引流量及有无血肿,并对有显著相关性的因素进行回归分析。结果两组的年龄、BMI、哺乳史、手术入路、假体品牌、假体表面性状、是否使用内窥镜及引流量等差异均无统计学意义(P>0.05),吸烟史、假体选择过大及血肿等因素与包膜挛缩的发生显著相关(P<0.05)。Logistic回归分析结果显示,在纠正了手术入路、假体表面性状及是否使用内窥镜后,吸烟史(OR=2.968,95%CI:1.385~6.365)、假体选择过大(OR=6.028,95%CI:2.448~14.845)及血肿(OR=14.560,95%CI:1.783~118.922)等因素仍与包膜挛缩呈正相关。结论吸烟史、假体选择过大及血肿增加了包膜挛缩的发生率,具体机制仍需进一步研究。Objective To explore the related factors of capsular contracture of prosthetic breast augmentation.Methods A retrospective controlled study was used to analyze the clinical data of 227 patients who underwent breast augmentation with silicone gel prosthesis from April 2019 to January 2020.According to whether capsule contracture occurred,the patients were divided into capsule contracture group and control group,followed up for 24 months.The age,BMI,smoking history,lactation history,surgical approach,prosthesis brand and surface properties,whether prosthesis was too large,whether endoscope was used,drainage volume and hematoma between the two groups were compared,and regression analysis was performed for the factors with significant correlation.Results There were no significant differences in age,BMI,lactation history,surgical approach,brand of prosthesis,surface traits of prosthesis,whether to use endoscope or not and drainage volume between the two groups(P>0.05).Smoking history,oversized prosthesis and hematoma were significantly correlated with the occurrence of capsular contracture(P<0.05).Logistic regression analysis showed that after correcting the surgical approach,prosthesis surface properties and whether or not to use endoscopy,smoking history(OR=2.968,95%CI:1.385-6.365),oversized prosthesis(OR=6.028,95%CI:2.448-14.845)and hematoma(OR=14.560,95%CI:1.783-118.922)were still positively correlated with capsular contracture.Conclusion Smoking history,excessive prosthesis selection and hematoma increase the incidence of capsular contracture,and the specific mechanism needs further study.

关 键 词：隆乳 吸烟史 包膜挛缩 假体过大 血肿 

分 类 号：R622[医药卫生—整形外科]