术前即刻超声定位在触诊阴性乳腺病灶切除术中的临床应用  

Preoperative"second eye"ultrosound guided orientation in non-palpable breast lesions surgery

作　　者：吕庆[1] 康莉 孙春雷[1] 管士明 Lv Qing;Kang Li;Sun Chunlei;Guan Shiming(Department of Breast Surgery,Affiliated Hospital of Jiangnan University(Wuxi No.4 People’s Hospital),Wuxi 214000,China;Department of Ultrasound,Affiliated Hospital of Jiangnan University,Wuxi 214000,China;Hua-Dong Sanatorium,Wuxi 214000,China)

机构地区：[1]江南大学附属医院甲乳外科,无锡214000 [2]江南大学附属医院超声科,无锡214000 [3]上海市华东疗养院,无锡214000

出　　处：《中华内分泌外科杂志》2020年第5期378-380,共3页Chinese Journal of Endocrine Surgery

摘　　要：目的探讨术前即刻超声引导下切除触诊阴性乳腺病灶的临床应用。方法选取2017年6月至2019年3月江南大学附属医院乳腺外科收治的100例临床触诊阴性超声检查阳性乳腺病患者,共136个病灶,应用随机数字表法分为观察组和对照组。对照组术前一天在B超室由超声科医生进行超声下的体表定位(肿块相对应的皮肤上用记号笔标记"+"),然后手术;观察组除了术前超声医生的体表定位,在手术室再次由主刀医生行术前即刻超声后再行手术。观察比较两组患者的手术时间、切除标本的体积及切口的平均长度等。结果所有病灶均被完整切除,对照组的手术时间平均为28min,切除标本体积平均为4.1 ml,切口平均长度为30 mm;观察组的手术时间平均为20min,切除标本体积平均为3.0 ml,切口平均长度为25 mm;两组手术时间和切除标本体积间差异有统计学意义(P值均<0.05),两组切口长度差异无统计学意义(P=0.12)。结论术前即刻超声定位对切除临床触诊阴性乳腺病灶更准确、安全、有效,可明显缩短手术时间,精准切除标本,减少切除病灶外组织,在临床工作中乳腺外科医生掌握乳房的超声图像特点,在手术中可起事半功倍的效果。Objective To investigate clinical application of preoperative"second eye"ultrosound guided orientation in non-palpable breast lesions surgery.Methods 100 patients were involved in the present study,with 136 impalpable breast lesions.Patients were divided into treatment group and control group by using random number table method.Patients of the control group were operated according to the preoperative ultrasonic location alone,while lesions of patients from the treatment group were located not only by preoperative surface location,but also by the"second eye"ultrasonic examination performed by surgeons.Volume of resected specimen and the operation time and the average length of incision were observed and compared between the two groups.Results All lesions were completely resected.The average operation time of the treatment and control groups was 20 minutes vs 28 minutes(P<0.05),the average volume of resected specimens was 3.0 ml vs 4.1 ml(P<0.05),and the average length of incision was 25 mm vs 30 mm(P=0.21).Conclusions It is an accurate,safe and effective method to remove clinical non-palpable breast lesions by the"second eye"ultrasound operated immediately before the surgery.It can obviously shorten the operation time,precisely remove the specimen,and reduce damage to normal tissues.In clinical practice,breast ultrasonic characteristics are recommended to be mastered by surgeons so that it could be helpful to the surgery.

关 键 词：乳腺手术 触诊阴性乳腺病灶 术前超声 

分 类 号：R655.8[医药卫生—外科学] R737.9[医药卫生—临床医学]