超声引导下乳腺旋切术在紧邻皮肤乳腺结节中的临床应用价值  

作　　者：孙希希 刘德林 黄斌 孔梓祥 洪霞 

机构地区：[1]杭州市西溪医院,310023

出　　处：《浙江临床医学》2020年第8期1186-1187,1190,共3页Zhejiang Clinical Medical Journal

摘　　要：目的 探讨超声引导下乳腺旋切术在紧邻皮肤乳腺结节中的临床应用价值.方法 选取105例距皮下≤0.2cm的乳腺结节,68例在本院行超声引导下乳腺结节旋切术,旋切组中所有结节均注射充分隔离液,超声多切面进行引导,采用适合的进针方式、侧切等方法等切除肿块.37例经手术切除作为对照组,观察两组结节一次性完全切除率、术后血肿形成、术后皮肤凹陷、术区疤痕增生等情况,并总结旋切术中有效的操作技巧.结果 68例乳腺旋切组中67例一次性完全切除,4例术后1周可见血肿形成,5例术后1周可见皮肤凹陷、2例术后1个月可见皮肤凹陷,所有病例术后3个月均无皮肤凹陷,所有病例均未发生皮肤切穿(0/68),2例术后3个月可见穿刺处疤痕增生,大小约0.5cm,与手术对照组在结节完全切除率、术后血肿形成上差异无统计学意义(P>0.05),在术后皮肤凹陷、术区疤痕增生上存在明显差异(P<0.05).结论 对于紧贴皮肤的乳腺肿瘤选用适当的进针方式、注射隔离液、旋转探头针进行侧切及超声实时、多切面的引导,能有效切除肿物,不残留、不损伤皮肤且并发症少.Objective To evaluate clinical value of ultrasound-guided Minimally invasive mammotome biopsy in breast nodules of adjacent skin.Methods A total of 105 breast nodules with subcuuneously less than 0.2 cm were selected.68 cases underwent ultrasound-guided breast nodule rotational resection in our hospital.All the nodules in the rotary cutting group were injected with adequate isolation fluid,guided by ultrasound on multiple cutting surfaces,and the tumor was excised by appropriate needling and lateral cutting methods.And 37 cases underwent surgical resection were selected as the control group.The One-time complete excision rate,postoperative hematoma formation,postoperative skin induration and scar hyperplasia of the nodules in the two groups were observed,and the effective operation techniques were summarized.Results In the rotatory group,67 patients underwent Onetime complete excision,hematoma was observed in 4 cases after operation of 1 week,skin depression in 5 cases after operation of 1 week,skin depression in 2 cases after operation of 1 month,no skin depression after operation of in 3 months,no skin incision(0/68)occurred in all cases,and 2 cases scar hyperplasia about 0.5cm after operation in 3 months.There was no significant difference in the total resection rate of nodules and the formation of postoperative hematoma between the two groups(P>0.05),but there were significant differences in the postoperative skin depression and scar hyperplasia in the operation area(P<0.05).Conclusion The selection of appropriate needle approach,injection of isolation fluid,rotating probe needle for side-cutting and real-time ultrasonic guidance of multiple sections can effectively remove the tumor without residual,skin damage and complications.

关 键 词：紧邻皮肤 乳腺旋切术 超声引导 侧切 皮肤凹陷 疤痕增生 

分 类 号：R73[医药卫生—肿瘤]