Chadbourne E B, Zhang S, Gordon M J, Ro E Y, Ross S D, Schnur P L, Schneider-Redden P R
MetaWorks Inc, 10 President's Landing, Medford, MA 02155, USA.
Mayo Clin Proc. 2001 May;76(5):503-10. doi: 10.4065/76.5.503.
This systematic review and meta-analysis were undertaken to determine whether reduction mammaplasty improves measurable outcomes in women with breast hypertrophy. A systematic review of the literature in 5 languages from 1985 until March 1999 was performed, and data were compared for meta-analysis. Eligible studies were both experimental and observational and involved women with preoperative physical and/or psychosocial signs and symptoms who underwent reduction mammaplasty for breast hypertrophy. Outcomes assessed were postoperative physical signs and symptoms such as shoulder pain, shoulder (bra strap) grooving, and quality-of-life domains, such as physical and psychological functioning, and were expressed primarily as risk differences (RDs). Twenty-nine studies of 4173 patients met all eligibility criteria. Reduction mammaplasty was associated with a statistically significant improvement in physical signs and symptoms involving shoulder pain (RD, 0.71 [95% confidence interval (CI), 0.62-0.80]); shoulder grooving (RD, 0.69 [95% CI, 0.60-0.78]); upper/lower back pain (RD, 0.59 [95% CI, 0.48-0.70]); neck pain (RD, 0.50 [95% CI, 0.37-0.64]); intertrigo (RD, 0.44 [95% CI, 0.34-0.54]); breast pain (RD, 0.36 [95% CI, 0.17-0.55]); headache (RD, 0.28 [95% CI, 0.11-0.46]); and pain/numbness in the hands (RD, 0.11 [95% CI, 0.04-0.18]). The quality-of-life parameter of physical functioning was also statistically significant (RD, 0.58 [95% CI, 0.44-0.71]), while psychological functioning was not significant (RD, 0.46 [95% CI, 0.00-1.00]). The evidence suggests that women undergoing reduction mammaplasty for breast hypertrophy have significant postoperative improvement in preoperative signs and symptoms, quality of life, or both.
本系统评价和荟萃分析旨在确定乳房缩小术是否能改善乳房肥大女性的可测量结局。我们对1985年至1999年3月期间的5种语言文献进行了系统评价，并对数据进行比较以进行荟萃分析。符合条件的研究包括实验性和观察性研究，涉及术前有身体和/或心理社会体征及症状且因乳房肥大接受乳房缩小术的女性。评估的结局包括术后身体体征和症状，如肩部疼痛、肩部（胸罩带）沟痕，以及生活质量领域，如身体和心理功能，主要以风险差异（RDs）表示。4173例患者的29项研究符合所有纳入标准。乳房缩小术与涉及肩部疼痛（RD，0.71 [95%置信区间（CI），0.62 - 0.80]）、肩部沟痕（RD，0.69 [95% CI，0.60 - 0.78]）、上/下背部疼痛（RD，0.59 [95% CI，0.48 - 0.70]）、颈部疼痛（RD，0.50 [95% CI，0.37 - 0.64]）、擦烂（RD，0.44 [95% CI，0.34 - 0.54]）、乳房疼痛（RD，0.36 [95% CI，0.17 - 0.55]）、头痛（RD，0.28 [95% CI，0.11 - 0.46]）以及手部疼痛/麻木（RD，0.11 [95% CI，0.04 - 0.18]）的身体体征和症状在统计学上有显著改善。身体功能的生活质量参数也具有统计学意义（RD，0.58 [95% CI，0.44 - 0.71]），而心理功能则无统计学意义（RD，0.46 [95% CI，0.00 - 1.00]）。证据表明，因乳房肥大接受乳房缩小术的女性在术前体征和症状、生活质量或两者方面术后均有显著改善。
