Villeneuve Paul J, Holowaty Eric J, Brisson Jacques, Xie Lin, Ugnat Anne-Marie, Latulippe Louis, Mao Yang
Centre for Chronic Disease Prevention and Control, Public Health Agency of Canada, Ottawa, Ontario, Canada.
Am J Epidemiol. 2006 Aug 15;164(4):334-41. doi: 10.1093/aje/kwj214. Epub 2006 Jun 15.
There is widespread concern about possible long-term health effects among women who have received breast implants for cosmetic purposes; few studies have reported on the mortality patterns of such women. The authors examined cause-specific mortality in a cohort of 24,558 women with breast implants and 15,893 women who underwent other plastic surgery procedures in Ontario and Quebec, Canada, between 1974 and 1989. Deaths through 1997 were identified through linkage to the national mortality database. The authors compared the mortality of women who received implants with that of the general population by using standardized mortality ratios; Poisson regression was used to perform internal cohort comparisons. Overall mortality was lower among women who received breast implants relative to the general population (standardized mortality ratio = 0.74, 95% confidence interval: 0.68, 0.81). In contrast, higher suicide rates were observed in both the implant (standardized mortality ratio = 1.73, 95% confidence interval: 1.31, 2.24) and other plastic surgery (standardized mortality ratio = 1.55, 95% confidence interval: 1.07, 2.18) patients. No differences in mortality were found between the implant and other surgeries group for any of the 20 causes of death examined. Findings suggest that breast implants do not directly increase mortality in women. Further work is needed to evaluate risk factors for suicide among women who undergo elective cosmetic surgery.
接受隆胸手术以达到美容目的的女性可能面临的长期健康影响受到广泛关注；很少有研究报道过这类女性的死亡模式。作者调查了1974年至1989年间在加拿大安大略省和魁北克省的24558名接受隆胸手术的女性以及15893名接受其他整形手术的女性的死因特异性死亡率。通过与国家死亡率数据库建立联系，确定了截至1997年的死亡情况。作者使用标准化死亡率比将接受隆胸手术的女性的死亡率与普通人群的死亡率进行比较；采用泊松回归进行队列内部比较。与普通人群相比，接受隆胸手术的女性总体死亡率较低（标准化死亡率比 = 0.74，95%置信区间：0.68，0.81）。相比之下，在接受隆胸手术的患者（标准化死亡率比 = 1.73，95%置信区间：1.31，2.24）和接受其他整形手术的患者（标准化死亡率比 = 1.55，95%置信区间：1.07，2.18）中均观察到较高的自杀率。在所检查的20种死因中，隆胸手术组和其他整形手术组之间在死亡率方面未发现差异。研究结果表明，隆胸手术不会直接增加女性的死亡率。需要进一步开展工作来评估接受择期美容手术的女性自杀的风险因素。
