【摘要】 目的 比较改良根治术与Ⅰ期经背阔肌乳房重建术对乳腺癌患者心理的影响及术后美观度。方法 回顾性分析2019年6月至2021年12月在新乡市某三甲医院就诊的乳腺癌患者的临床资料，将年龄、病程、受教育程度、患侧乳腺外形大小及病理分型相似的患者进行配对，最终纳入符合入选标准的患者50例，其中行Ⅰ期经背阔肌乳房重建术患者25例(重建组),行乳腺癌改良根治术患者25例(根治术式组)。采用社会影响量表(SIS)、)焦虑自评量表(SAS)、抑郁自评量表(SDS)、自尊水平量表(SES)、益处发现评定量表(BFS)进行心理状态评分；比较两组手术方式对乳房外观的改善情况及患者满意度。结果 根治术式组病耻感总得分[(58.04±2.85)分]、SAS得分[(64.28±3.34)分]高于重建组[(53.16±2.93)、(56.60±2.99)分],差异均有统计学意义(P<0.01)。重建组自尊水平、益处发现水平得分[(31.52±3.18)、(64.44±3.01)分]高于根治术式组[(27.80±1.94)、(60.32±2.66)分],差异均有统计学意义(P<0.05)。重建组术后外观优良率(92.00%)及患者满意度得分[(83.44±4.00)分]显著高于根治术式组[16.00%,(70.16±5.95)分],差异均有统计学意义(P<0.05)。结论 与改良根治术相比，Ⅰ期经背阔肌乳房重建术在治疗乳腺癌的同时能够维持乳腺外观良好形态，提高患者满意度，同时能降低患者病耻感，提高患者的自尊水平和益处发现水平，改善患者生活质量，帮助患者尽快走出肿瘤阴影，值得临床中进一步推广。更多还原

【Abstract】 Objective To compare the psychological effects of modified radical mastectomy and stage Ⅰ transverse latissimus dorsi breast reconstruction on breast cancer patients and postoperative aesthetics.Methods The clinical data of breast cancer patients attending a tertiary care hospital in Xinxiang City from June 2019 to December 2021 were retrospectively analyzed, patients with similar age, disease duration, education level, affected breast shape size and pathological staging were matched, and 50 patients who met the inclusion criteria were finally enrolled, including 25 cases with stage Ⅰ transverse latissimus dorsi breast reconstruction(the reconstruction group) and 25 cases with modified radical mastectomy(the radical mastectomy group).Psychological state scores were performed using the Social Impact Scale(SIS),Self-rating Anxiety Scale(SAS),Self-rating Depression Scale(SDS),Self-Esteem Level Scale(SES) and Benefit Discovery Rating Scale(BFS) scores; the improvement of breast appearance and patients′ satisfaction degree were compared between the two groups.Results The total sickness stigma score and SAS score in the radical mastectomy group [(58.04±2.85),(64.28±3.34)] were higher than those in the reconstruction group[(53.16±2.93),(56.60±2.99)],with statistically significant difference(P<0.05).The scores of self-esteem level and benefit discovery level in the reconstruction group [(31.52±3.18),(64.44±3.01)] were higher than those in the radical mastectomy group[(27.80±1.94),(60.32±2.66)],with statistically significant difference(P<0.05).Excellent post-operative appearance rate and the appearance satisfaction score in the reconstruction group [92.00%,(83.44±4.00)] were higher than those in the radical mastectomy group [16.00%,(70.16±5.95)],and the differences had statistical significance(P<0.05).Conclusion Compared with modified radical mastectomy, stage Ⅰ transverse latissimus dorsi breast reconstruction can maintain the good appearance of breast glands and improve patient satisfaction while treating breast cancer; meanwhile, it can reduce patient stigma, improve patients′ self-esteem and benefit discovery, improve quality of life, and help patients to get out of the shadow of tumors as soon as possible, which is worthy of further promotion in clinical practice.更多还原