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[即刻乳房重建对乳房切除术女性生活质量的影响]

[Immediate breast reconstruction effects on quality of life of women with mastectomy].

作者信息

de Oliveira Riza Rute, Morais Sirlei Siani, Sarian Luís Otávio

机构信息

Departamento de Tocoginecologia, Universidade Estadual de Campinas, Campinas, SP, Brasil.

出版信息

Rev Bras Ginecol Obstet. 2010 Dec;32(12):602-8. doi: 10.1590/s0100-72032010001200007.

Abstract

PURPOSE

to prospectively evaluate the effects of immediate breast reconstruction on the quality of life of women who underwent mastectomy.

METHODS

76 women that underwent mastectomy at Centro de Atenção Integral à Saúde da Mulher da Universidade Estadual de Campinas, in Campinas, São Paulo, Brazil, from August 2007 to December 2008, were included. Two groups were formed: 41 women who underwent mastectomy combined with immediate breast reconstruction (M+RI) and 35 that were subjected to mastectomy alone (M). The quality of life evaluation was assessed with the World Health Organization's questionnaire - Quality of Life (WHOQOL-100). The questionnaire was administered on three occasions: at the time of admission, one month after surgery, and again six months after surgery. The WHOQOL-100 scores were calculated according to analysis' guidelines by the World Health Organization. For comparison of the scores between groups, it was used the Student's t-test, Fisher exact test, chi-square test, and Mann-Whitney test. For the analysis of repeated measures over time, ANOVA and ANOVA for repeated measures were used.

RESULTS

at all time points evaluated, beginning with the preoperative assessment, the average quality of life scores of the M+IR Group were higher than those of the M Group, primarily in the "physical", "psychological", "level of independence" and "social relationships" domains of the questionnaire. Of the six areas covered by the questionnaire, three ("physical", "social relations", "environment") showed no significant differences between groups. The M+IR Group had a better score (15.5 to 14.9 for the M+IR and 14.3 to 14.2 for M; p=0.04) in the psychological domain. There was a significant reduction in the level of independence in the first month after surgery in both groups, with a significant recovery after six months.

CONCLUSIONS

the present results suggest that immediate breast reconstruction is significantly beneficial regarding the psychological aspects of quality of life, without affecting the patient's physical functionality.

摘要

目的

前瞻性评估即刻乳房重建对接受乳房切除术女性生活质量的影响。

方法

纳入2007年8月至2008年12月在巴西圣保罗坎皮纳斯州立大学妇女综合健康中心接受乳房切除术的76名女性。分为两组:41名接受乳房切除术并即刻乳房重建的女性(M+RI)和35名单纯接受乳房切除术的女性(M)。采用世界卫生组织的生活质量问卷(WHOQOL-100)评估生活质量。问卷在三个时间点进行发放:入院时、术后1个月和术后6个月。WHOQOL-100得分根据世界卫生组织的分析指南计算。为比较两组得分,采用了学生t检验、Fisher精确检验、卡方检验和Mann-Whitney检验。对于随时间的重复测量分析,采用方差分析和重复测量方差分析。

结果

从术前评估开始,在所有评估时间点,M+IR组的平均生活质量得分均高于M组,主要体现在问卷的 “身体”、“心理”、“独立水平” 和 “社会关系” 领域。问卷涵盖的六个领域中,三个(“身体”、“社会关系”、“环境”)组间无显著差异。M+IR组在心理领域得分更高(M+IR组为15.5至14.9,M组为14.3至14.2;p=0.04)。两组术后第1个月独立水平均显著下降,6个月后显著恢复。

结论

目前结果表明,即刻乳房重建在生活质量的心理方面有显著益处,且不影响患者的身体功能。

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