自主与基于植入物的乳房重建和长期精神障碍风险:一项追溯队列研究模拟了目标试验
Danbee Kang1,2,3, Woong Ki Park4, Chanwoo Park5
1Center for Clinical Epidemiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
International journal of surgery (London, England)
|January 23, 2026
概括
乳房切除术后的自主重建 (AR) 与基于植入物的重建 (IBR) 相比,与更高的心理健康障碍的长期风险有关. 这种风险在老年患者中更大,并持续多年,突出了需要量身定制的咨询.
科学领域:
- 在瘤学瘤学.
- 整形外科 整形外科 整形外科
- 精神病学是一个精神病学.
背景情况:
- 乳房切除术后的乳房重建旨在提高生活质量.
- 不同重建类型的长期心理影响尚未得到充分理解.
- 这项研究调查了自主重建 (AR) 与基于植入物的重建 (IBR) 后的精神障碍风险.
研究的目的:
- 为了评估与IBR相比,AR乳腺切除术后临床诊断的精神障碍的长期风险.
- 确定患有重建后心理困扰风险较高的患者子组.
主要方法:
- 目标试验模拟使用全国性的韩国医疗保险数据库 (2015-2023年).
- 包括24,930名接受了乳房切除和重建的妇女,AR与IBR组的 1:3倾向分数匹配.
- 主要结局:精神障碍 (焦虑,抑郁,PTSD等) 的首次诊断时间. 使用ICD-10-CM代码;使用考克斯模型进行分析.
主要成果:
- 自主重建 (AR) 与精神障碍的发病率高于基于植入物的重建 (IBR) [aHR 1.13; 95% CI, 1.07-1.19].
- 这种风险在50岁及以上的患者中更为明显.
- 延迟AR显示年轻患者 (<50岁) 的精神病风险较低,随着时间的推移,风险增加至重建后5年.
结论:
- 自主重建 (AR) 与心理障碍的长期风险增加有关,特别是在老年女性中.
- 研究结果强调,在关于幸存者护理的讨论中,需要针对特定年龄的心理咨询.
- 患者对重建类型的知情选择应考虑潜在的长期心理健康影响.
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