乳房切除术后重建患者中动画畸形对生活质量的影响。
The Impact of Animation Deformity on Quality of Life in Post-Mastectomy Reconstruction Patients.
作者信息
Becker Hilton, Fregosi Nicole
机构信息
Voluntary Faculty Member, Department of Plastic and Reconstructive Surgery, Cleveland Clinic Florida, Weston, FL, USA.
Affiliate Associate Professor, Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, FL, USA.
出版信息
Aesthet Surg J. 2017 May 1;37(5):531-536. doi: 10.1093/asj/sjw264.
BACKGROUND
Animation deformity after subpectoral breast implant placement has been documented; however, the actual prevalence and effect on patient quality of life has not been studied much.
OBJECTIVES
The purpose of this study was to show that all patients with subpectoral implants experience some degree of animation deformity and that it can affect their quality of life, including causing embarrassment and discomfort in reconstructed patients.
METHODS
Patients who underwent breast implant surgery were contacted for inclusion in the study. Patients were obtained from a single surgeon's practice but included patients operated on outside the practice, and those seen in the practice for a consultation. A six-item questionnaire was developed by the senior author (H.B.) and the medical student (N.F.) involved in the study, to assess quality of life related to animation deformity. Patients had their degree of animation deformity assessed by the senior author and a medical student.
RESULTS
Of 25 patients who agreed to the questionnaire and assessment, 20% had grade I distortion, 44% grade II, 24% grade III, and 12% grade IV. Of the patients questioned, 80% were bothered by an animation deformity and 45% of those patients were bothered to a significant degree (≥6 out of 10). In addition, 48% of patients felt that the animation deformity interfered with their daily life, and 28% (7/25) of patients underwent, or were scheduled to undergo, revision of their reconstruction at the time of interview. The degree of the clinically observed animation deformity was correlated with patient dissatisfaction, with an R value of 0.47 (P value = 0.0145).
CONCLUSIONS
All patients with subpectoral implant positioning will experience some degree of animation deformity. Especially in the reconstructed breast population, animation deformity, and its severity, affects patients' quality of life. Other approaches to reconstruction should be considered to prevent animation deformity in this population.
LEVEL OF EVIDENCE
背景
胸肌下乳房植入术后的动态畸形已有文献记载；然而，其实际发生率以及对患者生活质量的影响尚未得到充分研究。
目的
本研究旨在表明，所有胸肌下植入假体的患者都会经历一定程度的动态畸形，并且这会影响他们的生活质量，包括给乳房重建患者带来尴尬和不适。
方法
联系接受乳房植入手术的患者以纳入本研究。患者来自一位外科医生的诊所，但也包括在该诊所外接受手术的患者以及前来该诊所咨询的患者。参与研究的资深作者（H.B.）和医学生（N.F.）编制了一份六项问卷，以评估与动态畸形相关的生活质量。由资深作者和一名医学生对患者的动态畸形程度进行评估。
结果
在25名同意接受问卷调查和评估的患者中，20%为I级畸形，44%为II级，24%为III级，12%为IV级。在接受询问的患者中，80%受到动态畸形的困扰，其中45%的患者受到的困扰程度较大（10分制中≥6分）。此外，48%的患者认为动态畸形干扰了他们的日常生活，28%（7/25）的患者在接受访谈时已经进行了或计划进行乳房重建修复手术。临床观察到的动态畸形程度与患者的不满程度相关，R值为0.47（P值 = 0.0145）。
结论
所有胸肌下植入假体的患者都会经历一定程度的动态畸形。尤其是在乳房重建患者群体中，动态畸形及其严重程度会影响患者的生活质量。应考虑采用其他重建方法来预防该群体中的动态畸形。
证据级别
4级。
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