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目的:探讨应用牛心包补片联合假体植入行一期乳房再造术的临床效果。方法:回顾性分析2016年6月至2019年10月141例在天津医科大学肿瘤医院乳房再造科接受牛心包补片联合假体植入一期乳房再造术患者的临床资料。患者均为女性，年龄（38.8±8.5）岁（范围：13~60岁），体重指数（21.9±2.5）kg/mn 2（范围：16.0~32.3 kg/mn 2），均由病理学检查确诊为乳腺癌，其中原位癌39例，Ⅰ期46例，Ⅱ期40例，Ⅲ期16例。患者接受保留乳头乳晕或保留皮肤的全乳切除术联合前哨淋巴结活检或腋下淋巴结清扫，并应用牛心包补片于胸肌后行假体植入。采用n t检验、χ2检验、Fisher确切概率法、Logistic回归分析临床病理学资料与并发症的关系，记录患者术前术后外观和生活质量评分。n 结果:患者手术时间［n M（IQR）］为3.6（1.5）h（范围：3.0~6.5 h）。术后近期并发症发生率为22.0%（31/141），主要为假体取出20例，其中15例发生在前30例手术患者。随访时间为28（8）个月（范围：20~53个月），术后远期并发症主要为包膜挛缩［11.2%（14/125）］和假体移位［10.4%（13/125）］。多因素分析结果显示，假体体积≥300 ml（n OR=8.173，95%n CI：1.302~51.315，n P=0.021）和环乳晕切口（n OR=7.809，95%n CI：2.162~28.211，n P<0.01）是患者发生术后近期局部并发症的独立影响因素。术后2年Breast-Q量表评分乳房外形满意度为（71.7±15.5）分，术后效果满意度为（90.4±9.5）分，心理满意度为（90.7±17.1）分，性生活满意度为（70.1±25.1）分。出院前满意率为95.4%（134/141），术后2年17.6%（22/125）的患者有修整意愿。n 结论:假体体积≥300 ml和环乳晕切口是牛心包乳房补片联合假体植入一期乳房再造术后近期局部并发症的独立影响因素。完成学习曲线后，该术式的术后并发症发生率较低，手术时间短，美容效果和患者术后生活质量较高。“,”Objective:To examine the clinical effect of acellular bovine pericardium patch in implant based immediate breast reconstruction.Methods:The clinicopathological information of 141 breast cancer patients, who admitted to Department of Breast Reconstruction and Oncoplastic Surgery, Tianjin Medical University Cancer Hospital, underwent immediate mammoplasty with implants combined with acellular bovine pericardium patches were analyzed from June 2016 to October 2019. All patients were female, with the age of (38.8±8.5) years (range: 13 to 60 years). The body mass index was (21.9±2.5) kg/mn 2 (range: 16.0 to 32.3 kg/mn 2). There were 39 cases of duct carcinoma in situ, 46 cases of stage Ⅰ, 40 cases of stage Ⅱ and 16 cases of stage Ⅲ. All patients received nipple-areola-sparing mastectomy or skin-sparing mastectomy with sentinel lymph node biopsy or axillary lymph node dissection, and prosthesis implantation with sub-pectoralis combined with breast patch. The correlation of clinicopathological characters and complications was assessed by n t test, χn 2 test, Fisher′s exact probability method and Logistic regression. Pre-and post-operative aesthetic, quality of life scores eve recorded.n Results:The operation time (n M(IQR)) was 3.6(1.5) hours (range: 3.0 to 6.5 hours). The early postoperative complication rate was 22.0% (31/141), prosthesis removal was the main postoperative complication, accounting for 64.5% (20/31) of the total complications, of which 15 cases occurred in the first 30 patients. The follow-up time was 28(8) months (range: 20 to 53 months), The most frequent long-term complications were capsular contracture and implant displacement, with the incidence of 11.2% (14/125) and 10.4% (13/125), respectively. Multivariate analysis showed that prosthesis volume ≥300 ml (n OR=8.173, 95%n CI: 1.302 to 51.315, n P=0.021) and peri-areolar incision (n OR=7.809, 95%n CI: 2.162 to 28.211, n P<0.01) were independent relative factors for the occurrence of short-term postoperative local complications. After 2 years of operation, the score of breast appearance satisfaction was 71.7±15.5, postoperative effect satisfaction was 90.4±9.5, psychological satisfaction was 90.7±17.1, sexual satisfaction was 70.1±25.1. The immediate postoperative satisfaction rate at discharge was 95.4% (134/141), and 17.6% (22/125) of patients had the intention to received revision surgery.n Conclusions:Prosthesis volume ≥300 ml and peri-areolar incision were independent realtive factors for short-term local complications after bovine pericardium patch combined with prosthesis implantation in the immediate breast reconstruction. After completing the learning curve, the postoperative complications of the procedure could be decreased.