【摘要】 目的 比较一步法假体乳房重建术与两步法扩张器-乳房重建术在乳腺癌患者中的效果。方法 选取2021年1月至2022年12月江西省肿瘤医院收治的60例乳腺癌患者作为研究对象，按照随机数字表法分为观察组与对照组，每组30例。两组患者均行乳房切除术，对照组采用一步法假体乳房重建，观察组行两步法扩张器-乳房重建。比较两组患者临床相关指标、美容效果、生存质量、心理状态及并发症发生情况。结果 两组患者引流管留置时间比较，差异无统计学意义（P>0.05）。观察组住院时间长于对照组，住院费用高于对照组，美容效果总优良率高于对照组，并发症总发生率低于对照组，差异有统计学意义（P<0.05）。两组患者术后1年情感、生理、功能、社会及家庭以及附加维度评分均高于本组术前，且观察组评分均高于对照组，差异有统计学意义（P<0.05）。两组患者术前抑郁自评量表（SDS）、焦虑自评量表（SAS）评分比较，差异无统计学意义（P>0.05）；两组患者术后1年SDS、SAS评分均低于本组术前，且观察组评分低于对照组，差异有统计学意义（P<0.05）。结论 乳腺癌患者植入物乳房重建术采用一步法或两步法均能恢复乳房形态，前者恢复快、成本低，但后者并发症少、美容度高，更有利于改善患者心理状态，提升生存质量，临床可根据患者实际情况合理选择重建方案。更多还原

【Abstract】 Objective To compare the effects of one-step prosthesis breast reconstruction and two-step expander-breast reconstruction in patients with breast cancer. Methods Sixty breast cancer patients admitted to Jiangxi Cancer Hospital from January 2021 to December 2022 were selected as the research objects, and they were divided into the observation group and the control group according to the random number table method, with 30 cases in each group. Both groups of patients underwent mastectomy. The control group received one-step prosthesis breast reconstruction, while the observation group underwent two-step expander-breast reconstruction. The clinical relevant indicators, cosmetic effects, quality of life,psychological states and the occurrence of complications of the two groups of patients were compared. Results There was no statistically significant difference in the indwelling time of the drainage tubes between the two groups of patients(P>0.05).The hospitalization time of the observation group was longer than that of the control group, the hospitalization cost was higher than that of the control group, the total excellent and good rate of cosmetic effect was higher than that of the control group,and the total incidence of complications was lower than that of the control group, the differences were statistically significant(P<0.05). After operation, the scores of emotion, physiology, function, society and family, as well as additional dimensions of the two groups of patients were all higher than those before operation, and the scores of the observation group were all higher than those of the control group, with statistically significant differences(P<0.05). There were no statistically significant differences in the scores of the self-rating depression scale(SDS) and the self-rating anxiety scale(SAS) before operation between the two groups of patients(P>0.05). After operation, the SDS and SAS scores of both groups were lower than those before operation, and the scores of the observation group were lower than those of the control group, the differences were statistically significant(P<0.05). Conclusion Breast reconstruction with implants for breast cancer patients can restore the breast shape by either one-step or two-step methods. The former has faster recovery and lower cost, but the latter has fewer complications and higher cosmetic degree. It is more conducive to improve the psychological state of patients and enhancing the quality of life. Clinically, the reconstruction plan can be reasonably selected according to the actual situation of patients.更多还原