超声引导下EnCor乳腺微创手术不同操作方法的临床应用  

Clinical application of ultrasound-guided EnCor breast system in breast masses of different operations

作　　者：王力 肖献秋 芮小平 WANG Li;XIAO Xian-qiu;RUI Xiao-ping(Department of Breast and Thyroid Surgery,the 904th Hospital of the Joint Logistics Support Force,PLA,Wuxi 214044,Jiangsu,China)

机构地区：[1]解放军联勤保障部队第九○四医院甲乳外科,无锡214044

出　　处：《东南国防医药》2020年第6期612-616,共5页Military Medical Journal of Southeast China

摘　　要：目的探讨超声引导下EnCor乳腺微创手术中超声探头定位与旋切刀头不同的操作方法的临床应用价值。方法回顾性分析2016年2月至2019年7月期间解放军联勤保障部队第九○四医院甲乳外科就诊的279例(包括乳房良性肿块女性患者276例及乳腺增生男性患者3例)接受超声引导下EnCor乳腺微创旋切手术患者的临床资料,分别分析比较超声探头采用平移法185例和十字定位法94例进行术中肿块定位,EnCor旋切刀头采用侧入法169例和正后入路法110例进行手术旋切操作之间的临床疗效。结果279例均成功完成手术,术中发生皮肤误切导致凹陷、破损12例;因术中出血压迫止血无效转为开放手术2例;术后3个月复查发现肿块部分残留14例;术后24 h内出现血肿9例,所有血肿均在1.5个月内吸收消失。术后均无感染发生、无明显的乳房变形及瘢痕形成。术后常规病理示乳腺腺病伴纤维腺瘤262例,脂肪瘤14例,男性乳腺腺体增生3例。超声探头采用平移法出现肿块残留率[2.16%(4/185)]低于十字定位法[10.60%(10/94)],差异有统计学意义(P<0.05);其他并发症发生率比较差异均无统计学意义(P>0.05)。EnCor旋切刀头侧入法出现皮肤误切导致凹陷、破损发生率[1.18%(2/169)]低于正后路入法[9.09%(10/110)],差异有明显统计学意义(P<0.01);其他并发症发生率比较差异均无统计学意义(P>0.05)。结论EnCor乳腺微创旋切手术中超声探头采取平移法操作,旋切刀头采取侧入法操作,有定位准确、肿块切除完整、术中操作安全、乳房无变形等优点,在微创手术操作中是较好的选择,显示出微创手术的优势和价值。Objective To investigate the application value of ultrasound-guided EnCor system with different operations of the ultrasonic probe and EnCor biopsy probe.Methods A retrospective cohort study of 279 patients(276 female breast benign masses and 3 gynecomastia patients)received ultrasound-guided EnCor system surgical operation was admitted between February 2016 and July 2019 in department of breast and thyroid of 904 hospital of PLA Joint Logistics Support Force.A randomized clinical trial on the curative effect of 185 translations constantly and 94 cross-shape positioning of ultrasonic probe,the EnCor biopsy probe operational approach of 169 posterior and 110 right astern were evaluated.Results The physical condition of 279 patients were evaluated good preoperative and operated successfully.The skin of 12 patients were incidental excised lead to skin dimpling or damaged intraoperative;2 patient was converted to open rhinoplasty approach caused by blood soss intraoperative which hemostasis by compression unsuccessfully;Partial residual masses of 14 cases was reviewed 3 month postoperation;Postoperative hemorrhage was found in 9 patients and disappeared within 1.5 months.All cases were completed without infection,obvious breast deformation and scar formation.Postoperative convention pathology showed 262 cases of breast adenosis or fibroadenoma,3 cases of gynecomastia,and 14 of lipomyoma.Within the translation constantly and Cross-shape positioning of ultrasonic probe,the partial residual masses incidence rate of translation[2.16%(4/185)]was lower than that of cross-shape positioning[10.60%(10/94)],which had statistically significance(P<0.05);the incidence of other complications had not much distance(P>0.05);The skin dimpling or damaged intraoperative of incidence rate of EnCor biopsy probe operational approach of posterior[1.18%(2/169)]was lower than that of right astern[9.09%(10/110)].There was statistically significant(P<0.01),and no significance between other complications.Conclusion To the EnCor minimally invasiv

关 键 词：EnCor乳腺微创旋切术 超声探头定位 旋切刀头操作 肿块残留 皮肤误切 

分 类 号：R737.9[医药卫生—肿瘤]