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肥胖患者巨乳症行缩乳术后的生活质量及症状缓解情况:手术是否值得?

Quality of Life and Alleviation of Symptoms After Breast Reduction for Macromastia in Obese Patients: Is Surgery Worth It?

作者信息

Güemes Antonio, Pérez Esther, Sousa Ramón, Gil Ismael, Valcarreres Maria Pilar, Carrera Patricia, Gracia Maria Dolores, Artigas Luis, Gascon Ana

机构信息

Department of Surgery, University Hospital Zaragoza, Av. San Juan Bosco 15, 50009, Saragossa, Spain.

Department of Surgery, University Hospital "Lozano Blesa", Av. San Juan Bosco 15, 50009, Saragossa, Spain.

出版信息

Aesthetic Plast Surg. 2016 Feb;40(1):62-70. doi: 10.1007/s00266-015-0601-x. Epub 2015 Dec 30.

Abstract

BACKGROUND

Breast hypertrophy can cause a variety of symptoms and affect lifestyle and quality of life. Breast reduction, being the most effective treatment, is sometimes difficult to establish as standard treatment in obese patients (difficulties to differentiate symptoms from macromastia or from obesity, higher rate of complications).

AIM

To evaluate the effect of reduction mammaplasty (quality of life and symptoms) in obese patients comparing with non-obese.

METHODS

This is a prospective study of patients undergoing reduction mammaplasty. Patients were allocated in non-obese (BMI < 29) and obese (BMI > 30). Demographic data, comorbidities, specific symptoms questionnaire, data from the surgical procedure, Spanish version of the Health-Related Quality of Life (SF-36) questionnaire, complications and sequels were recorded and collected before the operation and at 1 month and 1 year after. Chi-square, Fisher's exact t test, McNemar, Mann-Whitney U and Kruskal-Wallis tests were used for statistical analysis.

RESULTS

One hundred twenty-one consecutive patients were operated on; 54 (44.6 %) obese and 67 (55.4 %) non-obese. The average age of patients was 40.7 (18-78), average volume of resected tissue was 1.784 g (401-5.790), and average hospital stay was 2.94 days (1-11). There were no differences between obese and normal BMI patients with regard to length of hospital stay, complications, sequels, or reoperations. Symptoms improved in both groups. Physical and mental components of the SF-36 improved at 1 year in both groups (p < 0.001). The mental health component improved at 1 month (p < 0.001) in both groups.

CONCLUSIONS

Obese patients should be considered for reduction mammaplasty surgery in the same way as women of normal weight.

LEVEL OF EVIDENCE III

This journal requires that authors assign a level of evidence to each submission to which Evidence-Based Medicine rankings are applicable. This excludes Review Articles, Book Reviews, and manuscripts that concern Basic Science, Animal Studies, Cadaver Studies, and Experimental Studies. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

摘要

背景

乳房肥大可导致多种症状,并影响生活方式和生活质量。乳房缩小术作为最有效的治疗方法,在肥胖患者中有时难以成为标准治疗方法(难以区分症状是由巨乳症还是肥胖引起,并发症发生率较高)。

目的

评估肥胖患者与非肥胖患者相比,乳房缩小术(生活质量和症状方面)的效果。

方法

这是一项对接受乳房缩小术患者的前瞻性研究。患者被分为非肥胖组(BMI < 29)和肥胖组(BMI > 30)。记录并收集手术前、术后1个月和1年的人口统计学数据、合并症、特定症状问卷、手术数据、西班牙语版健康相关生活质量(SF - 36)问卷、并发症及后遗症情况。采用卡方检验、Fisher精确t检验、McNemar检验、Mann - Whitney U检验和Kruskal - Wallis检验进行统计分析。

结果

连续121例患者接受了手术;54例(44.6%)为肥胖患者,67例(55.4%)为非肥胖患者。患者平均年龄为40.7岁(18 - 岁),平均切除组织量为1.784克(401 - 5.790克),平均住院天数为2.94天(1 - 11天)。肥胖患者与正常BMI患者在住院时间、并发症、后遗症或再次手术方面无差异。两组症状均有改善。两组患者SF - 36的生理和心理维度在术后1年均有所改善(p < 0.001)。两组患者心理健康维度在术后1个月均有所改善(p < 0.001)。

结论

肥胖患者应与正常体重女性一样,考虑进行乳房缩小术。

证据水平III:本刊要求作者为每篇适用循证医学排名的投稿指定证据水平。这排除了综述文章、书评以及涉及基础科学、动物研究、尸体研究和实验研究的稿件。有关这些循证医学评级的完整描述,请参考目录或作者在线指南www.springer.com/00266。

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