乳腺癌保留乳头乳晕切除即刻乳房重建术后患者生活质量的评价

目的:观察分析保留乳头乳晕乳腺切除术后即刻假体乳房重建术患者的美容效果和生活质量。方法:回顾性分析陕西省人民医院2015年5月至2016年9月收治并行保留乳头乳晕乳腺切除术后即刻假体乳房重建组（20例）与乳腺切除+前哨淋巴结活检术组（20例）的乳腺癌患者临床病理资料，术后就乳房重建的美容效果及随访1年生活质量等数据进行组间比较。结果:两组的平均年龄、TNM分期及文化程度等资料差异均无统计学意义（P＞0.05）；随访1年两组生活质量通过乳腺癌患者生命质量测定量表评价结果表明，重建组在社会/家庭状况、情感状况、功能状况、附加关注方面的得分均高于对照组，重建组显著优于对照组（P＜0.05）；而在生理状况评分方面无明显差异。结论:保留乳头乳晕乳腺切除术后即刻假体乳房重建术较乳腺切除+前哨淋巴结活检手术具有创伤小、效果良好、外形美观、生活质量高等优势，值得临床推广。

Evaluation of the quality of life of immediate breast reconstruction after nipple-sparing mastectomy in breast cancer patients

Objective:To observe and analyse of the cosmetic results and quality of life of breast reconstruction with immediate prosthesis implantation after nipple-sparing mastectomy.Methods:The clinicopathological data of breast cancer patients who had undergone IBR after nipple-sparing mastectomy（20 cases) and mastectomy combined with sentinel lymph nodes biopsy（20 cases) in Shaanxi Provincial People's Hospital from May 2015 to September 2016 were retrospectively analyzed.The data of postoperative breast reconstruction and follow-up one-year quality of life were compared between groups.Results:There was no significant difference in the mean age,TNM stage and educational level between the two groups（P＞0.05).The quality of life of the two groups was followed up for 1 year.The evaluation results of the quality of life questionnaire for breast cancer patients showed that in the IBR group,social/family status,emotional status,functional status,additional attention scores were higher than the control group,the IBR group was significantly better than the control group（P＜0.05),while in the physiological status score no significant difference.Conclusion:Breast reconstruction with immediate prosthesis implantation after nipple-sparing mastectomy is better than the mastectomy combined with sentinel lymph nodes biopsy with less trauma,good effect,beautiful appearance and high quality of life,which is worthy of clinical promotion.