乳管镜下置定位针在乳管内肿瘤手术中的应用价值  

Clinical application of localization needle under mammary ductoscopy for surgical excision of intraductal neoplasms

作　　者：朱旬[1] 邢春根[1] 金涛[1] 蔡立春[1] 

机构地区：[1]苏州大学附属第二医院普外科,江苏省215004

出　　处：《中华普通外科杂志》2010年第9期748-750,共3页Chinese Journal of General Surgery

摘　　要：目的 探讨经乳管镜置定位针引导的方法在乳管内肿瘤手术中的应用价值.方法 2009年1月至2010年3月,苏州大学附属第二医院76例采用乳管镜检查发现乳管内肿瘤的患者随机分为2组,每组各38例,分别在美兰标记和置定位针后进行手术,比较两组手术时间、切除标本重量、切口长度及手术前后诊断符合率.结果 定位组手术时间短于美兰组（31±8 min vs.42±9 min） 定位组手术切除标本重量轻于美兰组（1.51±1.36 g vs.2.95±2.07 g） 切口长度小于美兰组（34.4±7.1 mm vs.23.2±7.8 mm）,差异均有统计学意义（P＜0.05）.两组中乳管镜下诊断为乳腺癌者,手术后病理诊断均被证实,但定位组诊断符合率高于美兰组（94.7%vs.76.3%）.结论 乳管镜下置定位针有助于精确定位病变乳管及肿瘤位置,缩小手术范围,减小手术创伤,可作为术前常规应用于临床.Objective To evaluate the clinical value of breast localization needle placed via mammary ductoscopy in surgical treatment of patients with intraductal neoplasms. Methods In this study,76 patients with intraductal neoplasms diagnosized by mammary ductoscopy from January 2009 to March 2010 in the Second Affiliated Hospital of Soochow University were randomly divided into two groups.For methylene blue group,ducts with the lesion were marked by methylene blue injection before operation.For localization needle group,ducts were marked by localization needle placed via ductoscopy.The operative time,specimen weight,incision length and diagnostic coincidence rate were compared among the two groups. Results Compared to the methylene blue group,the localization needle group had a significantly shorter operative time （31 ± 8 min vs.42 ± 9 min）,lighter specimen weight （1.51 ± 1.36 g vs.2.95 ± 2.07 g）,and shorter incision （23.2 ± 7.8 mm vs.34.4 ± 7.1 mm）.All the breast cancer cases dianosised by mammary ductoscopy were confirmed by postoperative pathology,but the localization needle group had a higher diagnostic coincidence rate than the methylene blue group （94.7% vs. 76.3%）. Conclusion Localization needle under mammary ductoscopy is a reliable technique for localizing intraductal neolasms.The surgical excision guided by localization needle is accurate and less traumatic,and should be a routine method marking the tumor involved duct before operation.

关 键 词：乳腺肿瘤 内窥镜检查 乳头溢液 乳腺定位针 

分 类 号：R686[医药卫生—骨科学]