MRI引导下乳腺穿刺定位术的护理应用  

Nursing during MRI-guided Breast Puncture Localization

作　　者：盛浏丽[1] 郭震[1] 赵玉年[1] 沈文荣[1] 张佳[1] 董珉[1] 

机构地区：[1]江苏省肿瘤医院放射科,南京210009

出　　处：《齐齐哈尔医学院学报》2015年第29期4474-4476,共3页Journal of Qiqihar Medical University

基　　金：江苏省卫生厅指导性科研项目基金资助(Z201209)

摘　　要：目的总结MRI引导下乳腺穿刺定位术的护理方法及体会。方法回顾性分析52例仅MRI上显示的病灶而B超及钼靶难以显示的隐匿病灶。全部病灶BI-RADS分类4或4以上。采用1.5T超导MRI机,乳腺MRI专用定位活检穿刺架及乳腺MRI专用定位针和定位导丝。根据MRI检查发现可疑病灶的部位选择外侧位、内侧位或轴位行定位。论述MRI引导下定位预约、术前、术中及术后的护理方法。结果 52例病灶均一次顺利完成定位,穿刺定位成功率达100%。病理切片证实病变完全切除,病理结果示乳腺导管内癌8例,浸润型癌7例。乳腺导管内乳头状瘤病1例,乳腺导管上皮不典型增生7例,乳腺腺病伴高度增生17例,乳腺纤维腺瘤12例。患者均未发生感染、麻醉过敏、休克。结论对乳腺仅MRI显示的病灶而其他影像技术难以显示的隐匿病灶,MRI引导下的定位术是一种安全可靠的方法,为微创手术治疗提供了又一种精确导向的方法,而积极、有效的护理是保证乳腺穿刺定位成功率和减少并发症的关键。Objective To assess the nursing method and experience during MRI- guided breast puncture localization. Methods The datas of 52 non palpable breast lesions which were only visible under MRI but not visualized by mammography or ultrasound were analyzed. All of the breast lesions were BI- RADS 4 to 5.1. 5T MRI,special localization and biopsies puncture frame and localization probe and guide wire were used.According to the MRI results,positioning biopsy was performed in the lateral and medial position or axis line of the breast lesions. The nursing experience and method of pre- operation,intra- operation and post- operation in MRI- guided puncture localization were elaborated. Results The location and surgical excision were succeeded on the 52 patients and the success rate was 100%. The pathologic findings were as followed： 8 cases were ductal carcinoma in situ（ DCIS）,7 were invasive cancer,1 was intraductal papillomas,7 were atypical ductal hyperplasia（ ADH）,17 were breast adenosis,and 12 were fibroadenomas. All of the patients were without infection,anesthesia allergic or shock. Conclusions MRI- guided breast localization provides an accurate and safe method for the occult breast lesions and minimally invasive surgery. Also,it made up the deficiency of other imaging methods. Active and effective nursing is the key step to improve the success rate of puncture localization and to reduce the complications during the process.

关 键 词：乳腺肿瘤 磁共振成像 穿刺定位术 护理 

分 类 号：R446.8[医药卫生—诊断学]