CAJ | 학술논문

目的：评价乳腺癌术后即刻应用假体和生物膜进行乳房Ⅰ期重建的临床效果。方法随访2012年至2014年28例保留皮肤的乳房腺体全切术（SSM）患者，其中Ⅰ期用硅胶假体置入胸大肌后生物膜重建乳房下皱襞的患者19例（A组）；单纯硅胶假体置入，未使用生物膜的患者9例（B组）。比较两组患者术后1年内，假体外露、假体移位、血肿、包膜挛缩、感染和异物反应等并发症的发生率。结果 A组仅有1例发生血肿（5.26%），其他并发症均未发生；而B组有1例发生假体外露（11.11%）、2例发生假体移位（33.33%）、1例血肿（11.11%）、4例包膜挛缩（44.44%），未发生感染和异物反应。 B组假体移位和包膜挛缩率明显高于A组（P<0.05）。术后随访1年，所有病例均无乳腺癌局部复发和远处转移。结论联合应用假体和生物膜重建乳房，形态良好，满意度较高，并发症少，是SSM术后安全有效的乳房重建方法。
목적：평개유선암술후즉각응용가체화생물막진행유방Ⅰ기중건적림상효과。방법수방2012년지2014년28례보류피부적유방선체전절술（SSM）환자，기중Ⅰ기용규효가체치입흉대기후생물막중건유방하추벽적환자19례（A조）；단순규효가체치입，미사용생물막적환자9례（B조）。비교량조환자술후1년내，가체외로、가체이위、혈종、포막련축、감염화이물반응등병발증적발생솔。결과 A조부유1례발생혈종（5.26%），기타병발증균미발생；이B조유1례발생가체외로（11.11%）、2례발생가체이위（33.33%）、1례혈종（11.11%）、4례포막련축（44.44%），미발생감염화이물반응。 B조가체이위화포막련축솔명현고우A조（P<0.05）。술후수방1년，소유병례균무유선암국부복발화원처전이。결론연합응용가체화생물막중건유방，형태량호，만의도교고，병발증소，시SSM술후안전유효적유방중건방법。
Objective To evaluate the clinical outcome of one-stage breast reconstruction with prosthesis and dermal matrices after skin-sparing mastectomy (SSM). Methods From 2012 to 2014, 28 cases suffered breast cancer were received one stage breast reconstruction after SSM, and were divided into group A and group B. The silicone prosthesis and dermal matrices was performed in group A (n=19) to reshape the breast and strengthen the inframammary fold, and silicone prosthesis without dermal matrices was used in group B (n=9). The incidence of complication was compared between two groups 1 year after operation. Results In group A, only 1 case (5.26%) with hematoma was observed. In group B, 1 case (11.11%) with prosthesis exposure, 3 cases (33.33%) with prosthesis shelloft, 1 case (11.11%) with hematoma and 4 cases (44.44%) with capsular contracture were observed. There were significant differences between two groups in the evidence of prosthesis shelloft and capsular contracture (P<0.05). All the patients were followed up for 1 year, no local recurrence and distant metastasis were observed. Conclusion Combination with prosthesis and dermal matrices had a better breast shape, higher satisfaction and less complication. It was a safer and more effective method of breast reconstruction.