摘要目的 评估乳腺癌术后腹壁下动脉穿支(DIEP)皮瓣乳房重建患者满意度及术后并发症的发生情况.方法 对26例行DIEP皮瓣乳房重建的乳腺癌患者的满意度及并发症进行随访,乳房重建满意度采用美国Michigan乳房重建效果研究评价量表,包括总体满意度及美学满意度.结果 26例DIEP皮瓣均存活,21例获得随访结果.Michigan乳房重建总体满意度61.9％(13/21),美学满意度66.7％(14/21).年龄[≤40岁81.8％(9/11),＞40岁40.0％(4/10);P=0.049]、腹部手术史[无腹部手术史75.0％(12/16),有腹部手术史20.0％(1/5);P=0.027]为影响总体满意度的因素;体重指数(BMI)[BMI＜25 kg/m2 76.5％(11/17),BMI为25～30 kg/m2 50.0％(2/4);P=0.049]为影响美学满意度的因素.4例静脉淤血,1例局部脂肪坏死,1例皮瓣感染;1例腹肌力量减弱.结论 DIEP皮瓣乳房重建外形美观自然,供区并发症发生率较低.

abstractsObjective To evaluate satisfaction and complications of deep inferior epigastric perforator (DIEP) flaps breast reconstruction afer mastectomy in breast cancer patients.Methods The 26 consecutive breast cancer patients who underwent DIEP flap breast reconstruction were collected.General patient satisfaction and esthetic satisfaction with DIEP flap breast reconstruction were accessed using a study-specific questionnaire modified from the Michigan Breast Reconstruction Outcome Study.Results Flap success rate was 100％.The general satisfaction of DIEP breast reconstruction was 61.9％ (13/21),and the esthetic satisfaction was 66.7％ (14/21).Age (≤40 years old was 81.8％ [9/11],＞40 years old was 40.0％ [4/10],P=0.049) and previous abdominal wall surgery (no previous abdominal wall surgery was 75.0％ [12/16] and previous abdominal wall surgery was 20.0％ [1/5],P=0.027) were significant negative factors affecting general satisfaction;Body mass index (BMI ＜25 kg/m2 was 76.5％ [11/17],BMI 25-30 kg/m2 was 50.0％ [2/4],P=0.049) was a statistically significant factor associated with esthetic satisfaction.Four flaps presented venous congestion.One patient had fat necrosis and one had flap infection of the reconstructed breast.One patient had a decrease in abdominal rotational strength.Conclusions DIEP flap breast reconstruction will offer distinct advantages to patients,in terms of decreased donor-site morbidity and shorter recovery periods.