术前即刻乳管镜定位在血性乳头溢液中应用  

Application of fiberoptic doctoscopy-guided immediate preoperative localization in patients with bloody nipple discharge

作　　者：王波 郭小军 WANG Bo;GUO Xiao-jun(Department of Organ Transplantation and Breast Surgery,Sinopharm Dongfeng General Hospital,Shiyan 442000,P.R.China)

机构地区：[1]湖北医药学院附属东风医院器官移植乳腺外科

出　　处：《中华肿瘤防治杂志》2019年第23期1791-1794,共4页Chinese Journal of Cancer Prevention and Treatment

摘　　要：目的乳腺导管内病灶体积较小,对乳腺导管内病灶检出及定位存在一定困难。本研究探讨术前即刻纤维乳管内视镜(乳管镜)下确定乳腺导管内病灶位置,对乳头血性溢液患者导管内病灶手术切除定位的精确性。方法选取2006-12-01-2017-01-31湖北医药学院附属东风医院收治的190例单孔乳头血性溢液患者,分为观察组(术前即刻乳管镜下置定位针)78例和对照组(常规术前1d乳管镜下置定位针)112例,比较2组临床治疗资料及预后情况,分析2组乳管镜操作时间、切除标本质量、术后病理诊断阳性率、术后复发率等差异。结果观察组78例患者乳管镜操作时间为(12±5.6)min,与112例对照组(11±6.4)min比较,差异无统计学意义,t=1.057,P=0.292;观察组手术切除标本质量为(8.9±1.3)g,与对照组(9.2±1.4)g比较,差异无统计学意义,t=-1.420,P=0.158;观察组术后病理诊断阳性率为87.18%(68/78),与对照组的83.93%(94/112)比较,差异无统计学意义,χ~2=0.387,P=0.534;观察组术后复发率为0(0/69),低于对照组的5.77%(6/104),差异有统计学意义,χ~2=4.124,P=0.042。结论术前即刻乳管镜下置定位针对乳头血性溢液患者导管内病灶手术切除的定位精确且安全。OBJECTIVE Due to the less volume of intraductal breast lesions,it is difficult in detection and localization the lesions in intraductal.This study was to determine the accuracy of fiberoptic doctoscopy-guided immediate preoperative localization in patients with bloody nipple discharge.METHODS Patients treated in Affiliated Dongfeng Hospital of Hubei Universiy of Medicine with bloody nipple discharge in single breast duct were localized through fiberoptic doctoscopy.From December 12 th,2006 to January 31 st,2017,190 patients were divided into observation group(immediate preoperative localization)and control group(routine preoperative localization)to investigate the clinical and prognostic relevance of two group patients.RESULTS The operation duration,weight of surgical specimen and positive rate of pathological diagnosis in obser vation groups were(12±5.6)min,(8.9±1.3)g,87.18%(68/78),in control group were(11±6.4)min,(9.2±1.4)g,83.93%(94/112),respectively,there were no significant difference between two groups,t=1.057,P=0.292;t=-1.420,P=0.158;χ~2=0.387,P=0.534.The rate of postoperative recurrence in control group was 0(0/69),in observation group was 5.77%(6/104),which was significantly higher compared with observation group(χ~2=4.124,P=0.042).CONCLUSION The immediate preoperative localization through fiberoptic doctoscopy-guided in patients with bloody nipple discharge was accurate,which is worthy of clinical application.

关 键 词：术前即刻定位 纤维乳管内视镜 乳头血性溢液 诊断 

分 类 号：R655.8[医药卫生—外科学]