超声引导下真空辅助微创旋切系统治疗导管内乳头状瘤的临床研究  

Clinical Research of Ultrasound-guided Vacuum-assisted Biopsy System in the Treatment of Intraductal Papillomas

作　　者：崔智淼 骆成玉[1] 李鑫[1] 林华[1] 丁毅[1] 刘宝胤[1] 

机构地区：[1]首都医科大学附属复兴医院乳腺微创中心,北京100038

出　　处：《中国微创外科杂志》2016年第11期969-972,共4页Chinese Journal of Minimally Invasive Surgery

基　　金：北京市科学技术委员会"首都临床特色应用研究"(项目编号:Z131107002213145)

摘　　要：目的探讨超声引导下真空辅助微创旋切系统治疗导管内乳头状瘤的安全性和可行性。方法 2012年12月~2015年4月我院收治导管内乳头状瘤66例,按照患者意愿分别行超声引导下真空辅助微创旋切术（观察组,33例）与传统开放性手术（对照组,33例）,比较2组手术时间、术中出血量、乳腺引流量、引流时间、术后瘢痕长度和术后并发症发生率。结果 66例均顺利完成乳腺肿瘤切除术。与对照组相比,观察组术后瘢痕长度明显短[（0.7±0.2）cm vs.（3.0±0.6）cm,t=-20.891,P=0.000]。2组手术时间[（32.4±4.2）min vs.（30.3±6.5）min,t=1.559,P=0.124]、术中出血量[（25.3±3.1）ml vs.（26.8±4.3）ml,t=-1.626,P=0.109]、乳腺引流量[（24.9±3.4）ml vs.（26.2±4.4）ml,t=-1.343,P=0.184]、乳腺引流时间[（2.7±0.5）d vs.（2.8±0.5）d,t=-0.812,P=0.420]、术后瘀斑发生率[6.1%（2/33）vs.12.1%（4/33）,χ^2=0.183,P=0.669]、术后血肿发生率[12.1%（4/33）vs.6.1%（2/33）,χ^2=0.183,P=0.669]、术后感染发生率[3.0%（1/33）vs.12.1%（4/33）,χ^2=0.866,P=0.352]和术后复发率[6.1%（2/33）vs.15.2%（5/33）,χ^2=0.639,P=0.424]差异无统计学意义。结论超声引导下真空辅助微创旋切系统治疗导管内乳头状瘤安全、可行,具有明显的美观效果。Objective To investigate the safety and feasibility of ultrasound-guided vacuum-assisted biopsy system in the treatment of intraductal papillomas. Methods From December 2012 to April 2015,a total of 66 cases of intraductal papilloma,according to their own choice,received ultrasound-guided vacuum-assisted excision（ observational group,33 cases） or traditional open surgical operation（ control group,33 cases）,respectively. The operative time,intraoperative blood loss,breast drainage volume,drainage duration,length of postoperative scar and incidence of postoperative complications were compared between the two groups.Results The breast tumor resection was successfully completed in all the 66 cases. As compared with the control group,the length of the scar in the observation group was significantly shorter [（ 0. 7 ± 0. 2） cm vs.（ 3. 0 ± 0. 6） cm,t =- 20. 891,P = 0. 000]. There were no significant differences between the two groups in operation time [（ 32. 4 ± 4. 2） min vs.（ 30. 3 ± 6. 5） min,t = 1. 559,P =0. 124],intraoperative blood loss [（ 25. 3 ± 3. 1） ml vs.（ 26. 8 ± 4. 3） ml,t =- 1. 626,P = 0. 109 ],mammary gland drainage volume [（ 24. 9 ± 3. 4） ml vs.（ 26. 2 ± 4. 4） ml,t =- 1. 343,P = 0. 184],drainage time [（ 2. 7 ± 0. 5） d vs.（ 2. 8 ± 0. 5） d,t =- 0. 812,P = 0. 420 ],incidence of postoperative ecchymosis [6. 1%（ 2 /33） vs. 12. 1%（ 4 /33）,χ^2= 0. 183,P = 0. 669 ],incidence of hematoma [12. 1%（ 4 /33） vs. 6. 1%（ 2 /33）,χ^2= 0. 183,P = 0. 669 ],incidence of infection [3. 0%（ 1 /33） vs.12. 1%（ 4 /33）,χ^2= 0. 866,P = 0. 352 ],and recurrence rate [6. 1%（ 2 /33） vs. 15. 1%（ 5 /33）,χ^2= 0. 639,P = 0. 424].Conclusion Ultrasound-guided vacuum-assisted biopsy system is safe and feasible for intraductal papillomas,and has significantly cosmetic effects.

关 键 词：导管内乳头状瘤 超声引导 真空辅助旋切系统 

分 类 号：R737.9[医药卫生—肿瘤]