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。

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.