目的 筛选基于综合并发症指数（CCI）严重并发症的评分的危险因素。方法 收集苏州大 学附属第二医院整形美容外科 2017 年 1 月至 2020 年 8 月行乳房切除术后乳房再造患者资料 227 例。纳入数据包括人口统计变量、临床变量。结果 出现重大并发症评分（CCI ≥ 26.2）62 例（27.3%），轻微并发症评分（CCI < 26.2）165 例。自体瓣膜重建（OR = 4.69，P < 0.001）、BMI ≥ 30 kg/m2（OR = 7.87，P < 0.001）、 延迟重建（OR = 9.13，P < 0.001）、术前放疗（OR = 22.70，P = 0.006）为术后重大并发症评分的主要危险因 素。在住院时间方面 CCI ≥ 26.2 组显著长于 CCI < 26.2 组（13.5 vs. 8，P < 0.001）。结论 自体瓣膜重建、 BMI ≥ 30 kg/m2、延迟重建、术前放疗为术后重大并发症评分的主要危险因素，这对患者和外科医生做出乳房重建的决定是至关重要的。

Objective Using the comprehensive complication index（CCI）score to assess the impact of breast reconstruction on complication severity after mastectomy. Methods 227 patients who underwent breast reconstruction after mastectomy from January 2017 to August 2020 in the plastic surgery department of the second affiliated hospital of Soochow university were collected. Data included demographic variables and clinical variables. Results 462 cases（27.3%）had major complications score（CCI ≥ 26.2），and 165 cases had minor complications score（CCI < 26.2）. Autologous valve reconstruction（OR = 4.69，P < 0.001），BMI ≥ 30 kg/m2（OR = 7.87，P < 0.001）， delayed reconstruction（OR = 9.13，P < 0.001）and preoperative radiotherapy（OR = 22.70，P = 0.006）were major risk factors for postoperative complications. In terms of hospitalization time，the CCI ≥ 26.2 group was significantly longer than the CCI < 26.2 group（13.5 vs. 8，P < 0.001）. Conclusions According to CCI score，Autologous valve reconstruction，BMI ≥ 30 kg/m2，delayed reconstruction，preoperative radiotherapy maybe the major postop⁃ erative complications，which are crucial for patients and surgeons when making breast reconstruction decisions.