乳腺癌术后即刻乳房再造治疗流程及其疗效

  目的  探讨建立乳腺癌切除术后即刻乳房再造合理治疗的临床意义及经济效益。  方法  应用SF-36健康量表对北京协和医院28例单侧乳腺癌术后即刻乳房再造及52例延迟乳房再造患者的健康相关指数进行调查, 并比较两组患者的平均住院费用、住院日、并发症发生率。  结果  术后随访1~5年, 两组患者健康相关指数与健康对照组比较差异无明显统计学意义。即刻再造患者平均总住院费用22 101.13元, 延迟再造22 691.90元(P < 0.05);即刻再造平均总住院日13.44 d, 延迟再造14.35 d(P < 0.05);即刻再造并发症发生率7.14%, 延迟再造7.69%(P>0.05)。  结论  应用合理的即刻乳房再造治疗流程, 能够保证医生在术中应用合理的切口对肿瘤进行最大限度地切除, 同时再造形态良好的乳房, 在减少肿瘤复发的同时获得更加满意的疗效。即刻乳房再造与延迟乳房再造相比, 能够减少平均住院日及住院费用, 并发症发生率无明显升高, 值得推广。

Protocol of Postmastectomy Immediate Breast Reconstruction for Patients with Breast Cancer and Its Outcomes

Objective To explore the clinical and financial significance of establishing an optimal protocol for immediate breast reconstruction after mastectomy.Methods Totally 28 women who underwent immediate reconstruction（IR）and 52 patients who underwent delayed reconstruction（DR）after mastectomy were enrolled in this study.The clinical outcomes were evaluated by SF-36 health survey.The average health care expenditures,duration of hospital stay,and complications were analyzed.Results Within 1-5 years of follow-up,no significant difference was found between these two groups and the healthy control group in all 8 dimensions of SF-36.The average health care expenditures and hospital days were significant lower in IR group than in DR group.Conclusion Immediate breast reconstruction has better economic and clinical outcomes than delayed breast reconstruction after mastectomy,and therefore deserves further application.