乳管内视镜在乳头溢液疾病中的诊治意义  

Ductoscopy in the evaluation of nipple discharge

作　　者：袁建达[1] 沈坤炜[1] 陆劲松[1] 韩企夏[1] 沈镇宙[1] 

机构地区：[1]上海医科大学肿瘤医院胸外科

出　　处：《上海医学》1999年第1期32-35,I000,共5页Shanghai Medical Journal

摘　　要：目的了解乳管内视镜检查在乳头溢液患者中的诊治意义。方法回顾性总结１９９７年１０月至１９９８年８月在我院门诊开展的１８０例乳管内视镜检查的表现、临床和随访结果，评价其诊治效果。结果１８０例乳头溢液患者中，导管扩张症者７４例，乳头状瘤者７９例，乳头状瘤病者６例，导管内癌３例，导管炎症１４例，其他４例。随访发现导管扩张症、导管内乳头状瘤、导管内癌、导管炎症乳管内视镜的诊断率分别为８８．９％、９１．１％、１００％、１００％。乳管内视镜下正常的乳管管壁光滑，表面光亮，分支有３～５级，最多７级；炎性导管有局部或广泛的充血，管壁欠光滑，散在絮状渗出物，经冲洗后可使管腔通畅，大多患者检查后无乳头溢液；管内乳头状瘤以单个多见，形状多样，表面大多光滑；乳腺癌一般表现为导管内弥漫性病变，颜色较苍白，伴絮状渗出。本检查安全检查后无一例出现乳头部的感染。结论对乳头溢液的患者而言，乳管内视镜检查是一项安全、经济、有效的检查方法；为乳腺疾病的早期发现。Objective Purposes To evaluate the role of ductoscopy in breast disease patients with nipple discharge.Methods 180 patients with nipple discharge undenwent ductal endoscopy in QRD of Shanghai Cancer Hospital from Oct. 1997 to Aug.1998. The procedure was discribed in detailes. Results The diagnostic rates of ductal endoscopy on dilatation of duct, intraductal papilloma, ductal cancer in situ and mastitis were 88.9%, 91.1%, 100% and 100%, respectively. The internal surface of a normal duct was lustrous and mooth, Cancer growing on the surface of the ductal wall appreared white and was slightly elevated, forming a bridging structure. The intraductal papi lomas appeared as intraductal nodules. Some patients with diagnosis of mastitis can be cured. Conclusion Ductal endoscopy is a harmless, useful and economic diagnostic procedure in the evaluation of nipple discharge.

关 键 词：乳腺癌 乳头溢液 乳管内视镜 

分 类 号：R737.9[医药卫生—肿瘤] R655.8[医药卫生—临床医学]