乳管镜诊断乳头溢液性疾病的后续治疗  

Subsequent treatment of nipple discharge after fiberoptic ductoscopic examination

作　　者：周才明[1] 黎绍基[1] 何健标[1] 

机构地区：[1]广州医学院第一附属医院普通外科,广州510120

出　　处：《中国微创外科杂志》2007年第4期344-345,349,共3页Chinese Journal of Minimally Invasive Surgery

基　　金：广东省自然科学基金资助项目(5300998);广州医学院科研基金资助项目(04-K-22)

摘　　要：目的探讨乳头溢液性疾病乳管镜诊断后的治疗措施。方法采用乳管镜对51例乳头溢液的病变导管进行观察、评估,并根据乳管镜下的不同表现特征实施治疗。乳头溢液性疾病的乳管镜下病变表现特征可分为隆起性病变和非隆起性病变,隆起性病变又分为结节状隆起和不规则隆起。本组结节状隆起29例,采取病灶局部切除23例,单纯乳腺切除6例;不规则隆起1例,病灶切除活检证实为乳腺癌后按恶性肿瘤的原则治疗;非隆起性病变21例,行乳管镜下冲洗治疗18例,3例有血性病变导管及其所属小叶切除术后石蜡切片病理诊断乳腺癌后按恶性肿瘤治疗。结果51例随访6～21个月,平均14个月,B超及胸片未见复发转移。结论乳管镜下的病变表现特征是乳头溢液性疾病制定治疗措施的重要依据。Objective To investigate subsequent treatment methods of nipple discharge after fiberoptic duetoseopic examination. Methods Intraductal lesions of 51 patients with nipple discharge were observed and assessed by fiberoptic ductoscopy. After examination, the patients were treated by various methods according to characteristic appearance of lesions under fiberoptic ductoscopy. The type of lesion with nipple discharge was classified as papillary lesions and nonpapillary ＇lesions. And the papillary lesions could be further subdivided into nodular papillary lesions and irregular papillary lesions. There were 29 cases of nodular papillary lesion, 23 of which were treated by local resection and 6 of which were given a simple mammectomy. There was 1 case of irregular papillary lesion, which was treated as malignant tumor after the focus was surgically removed and pathologically confirmed as breast cancer. Nonpapillary lesion was observed in 21 cases, 18 of which were treated by local irrigation under ductoscopy, and 3 of which were treated as malignant tumor after the abnormal duct with its lobules was pathologically diagnosed as breast cancer. Results The 51 patients were followed with B-uhrasonography or chest roentgenography for 6 -21 months（ mean, 14 months）. No recurrence or metastasis was observed. Conclusions The characteristic appearance of lesion with nipple discharge under fiberoptic ductoscopy is an important evidence for choosing treatment method.

关 键 词：乳头溢液 乳管镜 病变特征 治疗 

分 类 号：R655.8[医药卫生—外科学]