麦默通在乳腺良性肿块治疗中的应用研究  

Clinic study of mammotome minimally invasive operation in the treatment of benign breast lumps

作　　者：王健[1] 张丽娜[1] 顾林[1] 

机构地区：[1]天津医科大学肿瘤医院乳腺二科国家肿瘤临床医学研究中心乳腺癌防治教育部重点实验室天津市"肿瘤防治"重点实验室,300060

出　　处：《天津医药》2016年第4期385-388,共4页Tianjin Medical Journal

基　　金：国家自然科学基金面上项目(81202275);天津市自然科学基金资助项目(13JCQNJC11000)

摘　　要：目的探讨麦默通在乳房良性肿块切除中的应用价值及造成肿块残留的影响因素。方法 722例乳腺良性肿块患者经麦默通治疗,记录术中皮肤切口长度、旋切次数、出血量及手术时间。分析术后并发症构成,比较肿块残留在不同乳腺影像报告和数据系统（BI-RADS）分级、病灶数目及肿块大小等临床特征中的构成差异。Logistic回归分析肿块残留的影响因素。结果 722例患者的平均皮肤切口平均长度（6.25±1.92）mm、平均旋切（11.62±4.28）次、平均出血量（6.22±2.08）m L;切除组织条直径2.0~3.5 mm,平均长（13.69±5.06）mm;单个肿块平均切除时间（7.85±2.91）min。发生疼痛、局部红肿、淤青及血肿并发症者共33例（4.57%）,以疼痛（32例）和淤青（26例）为主。肿瘤肿块共1 367枚,以乳腺纤维腺瘤683枚（49.96%）为主。13例（1.59%）患者有肿块残留,肿块残留比例随病灶数目的增多而增加、肿块〉2 cm者高于肿块≤2 cm者、肿块边界不清者高于清晰者;有血肿、淤青形成者高于无血肿、淤青形成者（P〈0.01）。肿块〉2 cm、肿块边界不清晰、多发性肿块及有血肿形成为肿瘤残留的独立危险因素。结论麦默通微创旋切术治疗乳腺良性肿块安全有效。术前应综合评估肿块数目、大小及边界情况,以降低肿块残留风险。Objective To investigate the clinical application of mammotome minimally invasive techniques for benignbreast mass, and the risk factors of residual tumor. Methods A total number of 722 patients with benign breast mass re-ceived treatment of mammotome minimally invasive operation. Skin incision length, peeling times, blood loss and operationtime were recorded. The complications after surgery, the difference of constitution ratio in different BI-RADS grades, massnumber, mass volume and clinic features were analysed. The Logistic repression analysis was used to analyze risk factors ofmass residue. Results The average skin incision length was（6.25±1.92） mm in 722 patients, with an average peeling timesof（11.62±4.28） and average blood loss of（6.22±2.08） m L. The average diameter of removed tissue was 2.0-3.5 mm with anaverage length of（13.69±5.06） mm. An average operation time for single mass was（7.85±2.91） min. Complications weremainly pain（n=32） and bruising（n=26） in 33 patients（4.57%）. A total of 1 367 breast lumps were found in 722 patients, inwhich there were 683 fibroadenoma（49.96%）. Thirteen patients（1.59%） were found mass residue during follow-up. The pro-portion of mass residue was increased with the increased number of mass, and was higher in mass diameter above 2 cm thanin diameter less 2 cm, and also higher in tumor without clear boundary group than that with clear boundary group, and higherin patients with hematoma and bruising than that without hematoma and bruising. Mass diameter 2 cm, no clear boundary,multiple tumors and hematoma formation were independent risk factors of mass residue. Conclusion The mammotomeminimally invasive operation is a safe and potent therapeutic management for benign breast mass. Comprehensive evaluationof the tumor size, tumor boundary, the number of mass before operation can reduce the risk of mass residue.

关 键 词：乳腺疾病 外科手术 微创性 危险因素 麦默通 

分 类 号：R737.9[医药卫生—肿瘤]