超声引导下微创治疗乳腺脓肿的价值  

The superiority of ultrasound stereotactic guidance under mammotome minimally invasive treatment of breast abscess

作　　者：宋昌龙[1] 崔春国[1] 齐山[1] 金雄渊[1] 

机构地区：[1]吉林大学中日联谊医院乳腺甲状腺外科 吉林省乳腺疾病研究所,长春130000

出　　处：《中华医学超声杂志（电子版）》2012年第11期61-64,共4页Chinese Journal of Medical Ultrasound(Electronic Edition)

摘　　要：目的探讨超声引导下微创治疗乳腺脓肿的临床价值。方法 2008年1月至2011年1月我院收治56例乳腺脓肿患者共78个脓肿病灶。单侧乳房脓肿34例,双侧乳房脓肿22例。脓肿最大为9cm×7cm×4cm,最小为3cm×3cm×2cm。30例患者共42个脓肿病灶采用超声引导下微创治疗,26例患者共36个脓肿病灶采用传统手术治疗。结果行超声引导下微创治疗患者术后切口愈合及术腔完全闭合时间为7～9d,行传统手术治疗患者为9～20d,差异有统计学意义(P=0.045)。行超声引导下微创治疗患者术后切口瘢痕长度为0.3～0.5cm,小于行传统手术治疗患者的3～5cm。行超声引导下微创治疗患者一次手术治疗成功率为97.6%(41/42),行传统手术治疗患者一次手术治疗成功率为83.3%(30/36),差异有统计学意义(P=0.044);行超声引导下微创治疗患者术后均无复发(0/41),行传统手术治疗患者术后复发率为13.33%(4/30),差异有统计学意义(P=0.028)。结论超声引导下微创治疗乳腺脓肿可缩短术后切口愈合及术腔完全闭合时间,瘢痕小,一次手术治疗成功率较高,术后复发率低,是临床治疗乳腺脓肿的较好方法 。Objective The ultrasound-guided minimally invasive treatment was compared with conventional surgery of breast abscess including incision and drainage to evaluate its clinical value.Methods From January 2009 to January 2012,56 patients with breast abscess in our clinic were diagnosed,including 34 cases of unilateral breast abscess,22 cases of bilateral breast abscesses.So a total of 78 abscesses （maximum 9 cm × 7 cm × 4 cm,minimum 3 cm × 3 cm × 2 cm） were included in this study.The sizes of all abscesses in ultrasonography undertook statistical analysis and were divided into different categories.The patients voluntarily entered ultrasound-guided minimally invasive treatment group or traditional surgical treatment group.The treatment effect was observed and compared between the two groups.Results The treatment time of ultrasound stereotactic guided mammotome minimally invasive treatment group was 7-9 days,that of conventional surgery group was 9-20 days.The postoperative scars of minimally invasive treatment group were less than those of conventional surgery group and even were not obvious.The success rate of mammotome minimally invasive treatment group was 97.60% （41/42） and that of conventional surgery group was 83.30% （30/36）.The recurrence rate of mammotome minimally invasive treatment group was zero （0/41） and that of conventional surgery group was 13.33% （4/30）.Conclusions Ultrasonic three-dimensional positioning guided mammotome minimally invasive treatment of breast abscess can shorten treatment time and the scar is small.It is a safe and accurate treatment which has a low recur rate.In short,it is an ideal treatment method for breast abscess.

关 键 词：超声检查 介入性 外科手术 微创性 脓肿 乳腺疾病 

分 类 号：R655.8[医药卫生—外科学]