超声引导下导丝定位在切除不可触及乳腺病变中的应用  

Ultrasound-Guided Wire Localization for Locating and Removing Non-Palpable Breast Lesions

作　　者：姚峰[1] 万颖文[1] 李娟娟[1] 许志亮[1] 王冠楠[1] 司丕雷[1] 孙圣荣[1] 

机构地区：[1]武汉大学人民医院乳腺甲状腺外科,湖北武汉430060

出　　处：《武汉大学学报（医学版）》2012年第6期846-849,共4页Medical Journal of Wuhan University

基　　金：湖北省卫生厅重点资助项目(编号:JX3A14)

摘　　要：目的:比较超声引导乳腺病灶表面皮肤标记定位和超声引导下导丝定位两种定位方法在超声可及、临床不可及乳腺病灶切除术中的作用。方法:分析超声引导乳腺病灶表面皮肤标记定位和超声引导下导丝定位乳腺病灶后行开放手术切除病人的临床资料,比较其在定位率、定位时间、手术时间、标本重量、切除组织量/病灶组织量比值、手术标本切缘及并发症等方面的差异。结果:两组在病灶定位成功率上没有差别。超声引导乳腺病灶表面皮肤标记定位组定位时间(7 min)较超声引导下导丝定位组(18 min)明显缩短(P<0.01),但在手术时间上相反,前者需35 min,后者为23 min(P<0.01),手术切除标本重量前者(65 g)大于后者(43 g)(P<0.01),切除组织量/病灶组织量比值前者(150)亦大于后者(67)(P<0.01)。手术切缘阳性率及并发症发生率没有差别。结论:超声引导下导丝定位准确率高、可缩短手术时间,避免切除过多正常乳腺组织从而减少对乳腺外形的影响,是超声引导乳腺病灶表面皮肤标记定位方法较好的替代。Objective： To compare needle localization with skin marker localization in the resection of non-palpable breast lesions.Methods： The clinical data of 206 patients who underwent an excisional biopsy for non-palpable breast lesions with ultrasound guided needle localization or skin marker locatization were retrospectively analyzed.Patients＇ clinic pictures,radiological abnormalities,localization time,operation time,weight of the excised specimen,resection index（a ratio between the resection volume and the tumor volume）,clearance margins,and perioperative complications were assessed.Results： There were no difference between the two groups in terms of age,radiological abnormalities,and lesion size.Localization time was significantly reduced by skin marker localization.Otherwise,the duration of surgery was significantly reduced with the needle localization procedure.Both of the weight of the specimen and resection index were significantly lower in the needle localization group than in the skin marker localization group.The clearance margins and overall complication rate were similar for both groups.Conclusion： Our study suggested that the needle localization method is as effective as skin marker localization for the excision of non-palpable breast lesions.In addition,needle localization improved the outcomes by reducing operation time and preventing healthy tissue excision.

关 键 词：乳腺肿瘤 定位 手术 超声 

分 类 号：R655.8[医药卫生—外科学]