超声引导下乳腺良性结节微创旋切术后血肿预后及影响因素分析  

Analysis of prognosis and influence factors of hematoma of benign breast nodule post ultrasound-guided VABB

作　　者：董云云 张慧明[2] 史宪全[1] 钱林学[1] 柳曦[1] 赵军凤[1] 刘玉江[1] DONG Yun-yun;ZHANG Hui-ming;SHI Xian-quan(Department of Ultrasound,Beijing Friendship Hospital,Capital Medical University,Beijing 100050,China)

机构地区：[1]首都医科大学附属北京友谊医院超声科,北京100050 [2]首都医科大学附属北京友谊医院普外科,北京100050

出　　处：《中国医学装备》2021年第1期81-85,共5页China Medical Equipment

基　　金：北京市医院管理局“登峰”人才培养计划(DFL20180102)。

摘　　要：目的:探讨超声引导下乳腺良性结节微创旋切术后血肿形成影响因素及其预后。方法:选取有完整随访记录的68例(79枚结节)乳腺结节患者,对其均行超声引导下乳腺良性结节真空辅助微创旋切手术治疗,于术后24 h、1周、1个月、3个月以及6个月时超声复查血肿形成及吸收情况,分析血肿形成的影响因素。结果:68例患者术后24 h有44例形成血肿,术后一周血肿吸收4例(占9.1%),术后1个月血肿吸收19例(占43.2%),术后3个月血肿吸收40例(占90.9%),术后6个月血肿吸收43例(占97.7%)。多因素Logistics回归分析结果显示,非纤维腺瘤良性乳腺病变、周边组织结构以脂肪组织为主、结节深度≤0.65 cm或≥1.5 cm和血流信号Adler血流分级2级或3级为血肿形成的独立危险因素(OR=6.5,OR=6.8,OR=14.1,OR=4.7;P<0.05)。结论:超声引导下乳腺良性结节微创旋切术后血肿形成后无需特殊干预,可于6个月基本消失。非纤维腺瘤的良性乳腺病变、结节周边以脂肪组织为主、结节过深或过浅以及结节血流较丰富(血流信号Adler血流分级≥2级)是血肿形成的危险因素,此类结节应警惕血肿的形成。Objective:To investigate the influence factors and prognosis of hematoma of benign breast nodule post ultrasound-guided vacuum-assisted breast biopsy(VABB).Methods:68 patients with 79 benign breast nodules who had complete follow-up records were selected,and they underwent ultrasound-guided VABB.The formation and absorption of hematoma were reexamined by ultrasound at the 24th h,1th week,1th month,3th month and the 6th month post operation,respectively.And the influence factors of the formation of hematoma were further analyzed.Results:The hematoma occurred in 44 cases of 68 cases at the 24th h post operation,and the hematomas of 4 cases were absorbed at the 1th week post operation(9.1%),and that of 19 cases(43.2%)were absorbed at the 1th month post operation,and that of 40 cases(90.9%)were absorbed at the 3th month post operation,and that of 43 cases(97.7%)were absorbed at 6th month post-operation.The results of multi-factor Logistics regression analysis indicated the independent risk factors of hematoma formation included benign breast lesion of non-fibroadenoma,and the adipose tissue was the main part of the peripheral tissue structure,and the depth of nodule was less than or equal to 0.65 cm(or larger than or equal to 1.5 cm),and the Adler grading of blood flow signal was 2 grade or 3 grade(OR=6.5,OR=6.8,OR=14.1,OR=4.7,P<0.05).Conclusion:Generally,hematoma post ultrasound-guided VABB doesn’t require special intervention and it can disappear within 6 months.And the risk factors of hematoma formation include the benign breast lesion of non-fibroadenoma,and the adipose tissue is the main part of the peripheral tissue structure,and the depth of nodule is too deep or too shallow,and the blood flow of nodule is enricher(the Adler grading of blood flow signal is larger than or equal to 2 grade).And this kinds of nodule might form hematoma,and should be pay more attention.

关 键 词：真空辅助乳腺活检(VABB) 血肿 危险因素 预后 超声 

分 类 号：R445.1[医药卫生—影像医学与核医学]