纤维乳管内视镜在乳头溢液性疾病诊治中的应用  

Application of fiber-ductoscopy for nipple discharge

作　　者：王俊文 王森 王剑 杨敏 

机构地区：[1]山东省威海市妇女儿童医院,山东威海264200

出　　处：《中国现代普通外科进展》2006年第3期181-182,186,共3页Chinese Journal of Current Advances in General Surgery

摘　　要：目的:评价纤维乳管内视镜(FDS)在诊断治疗乳头溢液性疾病中的价值。方法:98例非哺乳期乳头溢液患者行109次乳管镜检查,分别进行药物灌注、乳腺病变导管小叶切除、乳腺象限切除、乳腺区段切除加前哨淋巴结活检术、乳腺切除加腋淋巴结清扫术。结果:乳管扩张症56例,行药物灌注治疗,54例症状消失,2例行手术治疗;化脓性乳管炎2例,均治愈;乳腺导管内乳头状病变34例(19例导管内乳头状瘤,15例导管内乳头状瘤病)行导丝定位下乳腺区段切除,其中5例行象限切除;3例导管内癌,行乳房切除或病变乳管在内的乳腺象限切除加前哨淋巴结活检,3例导管浸润癌,行乳房切除术加腋窝淋巴结清扫术,术后综合治疗,随访未见复发。讨论:FDS提高了乳头溢液的病因诊断率,因能直接观察到乳管上皮及导管腔内情况,据其制定治疗方案,减少患者损伤。Objective ：To evaluate the role of flber-ductoscopy （FIBS） on nipple discharge In diagnosis and treatment. Methods： 98 non-lactation patients with nipple bloody discharge underwent 109 flber-ductoscopy and , based on different ductoscopy diagnosis, were given Intrathoracic perfusion therapy, breast gland partial section excision,breast gland partial section excision ＋ Sentinel Lymph Node BIopsy （SLNB）, breast gland partial excision ＋ axlllary metastatic lymphnodes cleaning. Results ： 56 patients diagnosed as intraductal dilatation underwent Intrathoracic perfusion therapy,54 cases got healed,2 cases operated,2 suppurative mastitis patients got healed. 34 patients （with intreductal lesions 19 patients with Intraductal papillOma,and 15 patients intreductal papilloma disease） underwent breast gland partial excision. 5 patients underwent section excision. 3 with internal ductal carcinoma underwent breast section excision or breast section excision and Sentinel Lymph Node Biopsy （SLNB）. 3 who were dlagnosed as invasive ductal carcinoma and found cancer metastasis after underaolng breast section excision ＋ SLNB underwent axillary metastatic lymphnodes cleaning with combined therapy. No recurrence was found during follow-up. Conclusion：Throuah flber-ductoscopy, the cause of nipple discharae can be diagnosed,and we can set the finding of intreductal change on duct wall and lumen. According to the different diaanoses, we can succeed In healing the breast disease with nipple discharge, trying to achieve the minimally Invasive therapy.

关 键 词：乳溢 纤维乳管内视系统 乳腺疾病 

分 类 号：R655.8[医药卫生—外科学]