超声引导下真空辅助旋切手术治疗乳腺良性叶状肿瘤的疗效及术后局部复发的影响因素分析  

Analysis of the Effect of Ultrasound-guided Vacuum Assisted Circumcision in the Treatment of Benign Breast Phyllodes Tumor and the Influencing Factors of Postoperative Local Recurrence

作　　者：马靖靖[1] 宋文华[1] 刘小五[1] 燕小朋[1] 王晓丹 张磊[1] 陈莉[2] MA Jing-jing;SONG Wen-hua;LIU Xiao-wu;YAN Xiao-peng;WANG Xiao-dan;ZHANG Lei;CHEN Li(Department of Oncology Surgery,The Second Affiliated Hospital of Bengbu Medical College,Bengbu,Anhui,233000,China;Department of Breast Surgery,The First Affiliated Hospital of Anhui Medical University,Hefei,Anhui,230022,China)

机构地区：[1]蚌埠医学院第二附属医院肿瘤外科,安徽蚌埠233000 [2]安徽医科大学第一附属医院乳腺外科,安徽合肥230022

出　　处：《现代生物医学进展》2020年第22期4279-4282,4391,共5页Progress in Modern Biomedicine

基　　金：安徽省科技攻关计划项目(1401041122)。

摘　　要：目的:探讨超声引导下真空辅助旋切手术(VAE)治疗乳腺良性叶状肿瘤的疗效及术后局部复发的影响因素。方法:选取我院于2016年1月~2019年7月期间收治的乳腺良性叶状肿瘤患者100例,根据手术方式的不同分为A组(n=60,开放手术),B组(n=40,超声引导下VAE)。对比两组术中出血量、手术时间、伤口长度、住院时间、切口愈合时间、并发症发生率以及术后局部复发率。采用单因素及多因素Logistic回归分析术后局部复发的影响因素。结果:B组术中出血量少于A组,手术时间、伤口长度、住院时间、切口愈合时间均短于A组(P<0.05)。B组并发症发生率低于A组(P<0.05)。两组术后局部复发率对比无差异(P>0.05)。单因素分析结果显示,术后局部复发与肿瘤直径、同侧乳房纤维腺瘤史、核分裂有关(P<0.05)。多因素Logistic回归分析结果显示,肿瘤直径≥25 mm是乳腺良性叶状肿瘤患者术后局部复发的危险因素(P<0.05)。结论:与开放手术治疗相比,超声引导下VAE治疗乳腺良性叶状肿瘤可有效改善患者围术期指标,减少并发症发生率,同时乳腺良性叶状肿瘤患者术后局部复发与肿瘤直径密切相关。Objective: To investigate the efficacy of ultrasound-guided vacuum assisted circumcision(VAE) in the treatment of benign breast phyllodes tumor and analyze the influencing factors of postoperative local recurrence. Methods: 100 patients with benign benign breast phyllodes tumor admitted to our hospital from January 2016 to July 2019 were selected. The patients were divided into group A(n=60, open surgery) and group B(n=40, ultrasound-guided VAE) according to the different surgical methods. The intraoperative blood loss, operation time, wound length, hospitalization time, wound healing time, incidence rate of complications and postoperative local recurrence rate were compared between the two groups. Univariate and multivariate Logistic regression were used to analyze the influencing factors of postoperative local recurrence. Results: The intraoperative blood loss in group B was less than that in group A,and the operation time, wound length, hospitalization time and wound healing time in group B were shorter than those in group A(P<0.05). The incidence rate of complications in group B was less than that in group A(P<0.05). There was no significant difference in recurrence rate between the two groups(P>0.05). Univariate analysis showed that postoperative local recurrence were related to tumor diameter, ipsilateral breast fibroadenoma history and mitosis(P<0.05). Multivariate Logistic regression analysis showed that tumor diameter≥25 mm was a risk factor for local recurrence in benign breast phyllodes tumor patients(P<0.05). Conclusion: Compared with open surgery, ultrasound-guided VAE can effectively improve the perioperative index and reduce the incidence of complications. At the same time, the local recurrence of patients with benign breast tumor is closely related to the diameter of the tumor.

关 键 词：超声引导 真空辅助旋切手术 乳腺良性叶状肿瘤 疗效 复发 

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