摘要目的:探讨延迟即刻乳房再造中乳房扩张术相关的关键技术与并发症之间的关系，提出并发症防治策略。方法:2016年1月至2018年12月，在华中科技大学同济医学院附属协和医院整形外科实施乳房扩张术的女性乳腺癌患者48例(年龄32～48岁，平均42.7岁)，对这些患者乳房扩张术所涉及的关键技术及并发症情况进行分析。结果:48例患者中，扩张器埋置层次位于胸大肌后方，胸大肌附着点充分离断42例，表面覆盖组织完整45例，术中即刻注水47例。术后并发症包括扩张器移位(7例中6例为腔隙剥离不充分)、扩张不充分3例、感染1例。除1例感染患者取出扩张器外，47例患者均成功实施假体置换术。结论:胸大肌后方腔隙的充分剥离，扩张器表面软组织覆盖物的完整性、扩张器注水方式、包膜处理策略等技术是防治手术并发症的关键。

abstractsObjective:To summarize the essential techniques of breast expansion for delayed immediate breast reconstruction, and to explore the relationship between these techniques and complications, and so to provide strategy for complication management.Methods:The clinical data of 48 breast cancer patients that received breast expansion from January 2016 to December 2018 were investigated and analyzed to summarize the essential techniques and complications.Results:The expanders were placed in submuscular spaces in all of the 48 patients, muscular attachments were sufficiently dissected in 42 patients, expander coverage was intact in 45 patients, and immediate injection was carried out in 47 patients. The complications included expander malposition (7 cases), insufficient expansion (3 cases) and infection (1 case), and all those complications were properly managed except the infection case.Conclusions:Submuscular envelope, sufficient dissection, intact coverage, immediate injection and proper capsular management are the essential techniques of breast expansion for delayed breast reconstruction, as well as the keys of complication prevention and management.