微创旋切与传统手术治疗乳腺多发良性肿块的疗效比较  

Comparison the efficacy of minimally invasive surgery and traditional surgery in the treatment of multiple benign mammary lumps

作　　者：殷照才[1] 梅振宇[1] 盛勇[1] 陈剑平[1] 赵晚君 李琴 冯慧俊 沈忠兵[2] 彭辉[3] Yin Zhaocai;Mei Zhenyu;Sheng Yong;Chen Jianping;Zhao Wanjun;Li Qin;Feng Huijun;Shen Zhongbing;Peng Hui(Department of Thyroid and Breast Surgery, Yijishan Hospital of Wannan Medical College, Wuhu 241000, China;Department of Medical Ultrasonics, Yijishan Hospital of Wannan Medical College, Wuhu 241000, China;Department of Entry and Exit Management/Evidence-Based Medicine, Yijishan Hospital of Wannan Medical College, Wuhu 241000, China)

机构地区：[1]皖南医学院弋矶山医院甲乳外科,芜湖241000 [2]皖南医学院弋矶山医院超声医学科,芜湖241000 [3]皖南医学院弋矶山医院出入院管理科/循证医学教研室,芜湖241000

出　　处：《国际外科学杂志》2019年第5期329-333,共5页International Journal of Surgery

摘　　要：目的比较微创旋切与传统手术治疗乳腺多发良性肿块的临床效果。方法采用回顾性研究方法,选取2016年7月—2018年2月皖南医学院弋矶山医院收治的158 例乳腺多发良性肿块患者,均为女性;平均年龄(28.3±6.6)岁,范围19~51岁。根据手术方法的不同将患者分为微创组(n=122)和传统组(n=36),微创组患者采用微创旋切手术治疗,传统组患者采用传统手术治疗。比较两组患者的手术时间、切口数目、平均切口长度、累计切口长度及术后切口愈合时间,术后比较局部血肿、局部感染、乳腺畸形及局部残留发病率,并比较两组患者的满意度。正态分布的计量资料以均数±标准差(Mean±SD)表示,组间比较采用独立样本t检验;非正态分布的计量资料以中位数(四分位间距)[M(P25,P75)]表示,组间比较采用Mann-Whitney U检验;计数资料组间比较采用χ2检验或Fisher确切概率法。结果与传统组比较,微创组患者手术时间短(20.0 min 比40.0 min,Z=-8.590,P<0.001),切口少(1.0 个比2.0 个,Z=-4.423,P<0.001),平均切口长度短(3.8 mm 比35.5 mm,Z=-9.211,P<0.001),累计切口长度短(4.0 mm 比67.2 mm,Z=-9.130,P<0.001),术后切口愈合快(4.0 d 比7.0 d,Z=-9.334,P<0.001);两组患者术后局部血肿(4.1%比2.8%,χ2=0.000,P=1.000)、局部感染(0比2.8%,P=0.228)、乳腺畸形(1.6%比2.8%,χ2=0.000,P=1.000)]和局部残留发病率(0.8%比0,P=1.000)比较差异均无统计学意义;微创组患者术后满意度更高(95.1%比58.3%,P<0.001)。结论与传统手术相比,应用微创旋切手术治疗乳腺多发良性肿块具有手术时间短、切口少、切口长度短、切口愈合快及术后满意度高等多重优势,未明显增加术后并发症,值得临床推广与应用。Objective To compare the clinical efficacy of minimally invasive surgery and traditional surgery in the treatment of multiple benign mammary lumps.Methods A retrospective study was conducted to select 158 patients with multiple benign breast masses admitted to Yijishan Hospital of Wannan Medical College from July 2016 to February 2018,all of them were female,average age was (28.3 ± 6.6) years old,range from 19 to 51 years old.The patients were divided into minimally invasive group (n =122) and traditional group (n =36) according to different surgical methods.The minimally invasive group was treated by minimally invasive rotary excision,while the traditional group was treated by traditional surgery.The operation time,number of incisions,average length of incisions,cumulative length of incisions and healing time of incisions were compared between the two groups.The incidence of local hematoma,local infection,breast deformity and local residual were compared after operation,and the satisfaction of the two groups was aslo compared.Normal distribution measurements were expressed by mean ± standard deviation (Mean ± SD),independent sample t test was used for inter-group comparison;non-normal distribution measurements were expressed by median (quartile spacing) [M(P25,P75)],Mann-Whitney U test was used for inter-group comparison.Chi-square test or Fisher exact probability test was used to compare the count data between the two groups.Results As compared to the traditional group,the minimally invasive group had shorter operation time (20.0 min vs 40.0 min,Z =-8.590,P < 0.001),less number of incisions (1.0 vs 2.0,Z =-4.423,P <0.001),smaller average surgical incision length (3.8 mm vs 35.5 mm,Z =-9.211,P < 0.001),smaller cumulative surgical incision length (4.0 mm vs 67.2 mm,Z =-9.130,P < 0.001),quicker postoperative recovery (4.0 d vs 7.0 d,Z =-9.334,P < 0.001).There were no significant differences between the two groups in incidence of postoperative hematoma (4.1% vs 2.8%,χ2 =0.000,P =1.000),incidence of infection (0

关 键 词：乳腺肿瘤 真空 超声检查 外科手术 微创性 

分 类 号：R737.9[医药卫生—肿瘤]