纤维乳管镜在病理性乳头溢液治疗中的应用价值  

Application value of fiberoptic ductoscopy in the treatment of pathologic nipple discharge

作　　者：李智 史立晖 蒋宏传[2] 张超[2] 陈琦 张腾 张璐 王景 LI Zhi;SHI Lihui;JIANG Hongchuan;ZHANG Chao;CHEN Qi;ZHANG Teng;ZHANG Lu;WANG Jing(Department of Breast Surgery,Tongzhou Maternal and Child Health Hospital of Beijing,Beijing101101,China;Department of General Surgery,Beijing Chaoyang Hospital,Capital Medical University,Beijing100020,China)

机构地区：[1]北京市通州区妇幼保健院乳腺外科,北京101101 [2]首都医科大学附属北京朝阳医院普外科,北京100020

出　　处：《中国医药导报》2022年第4期99-102,共4页China Medical Herald

基　　金：北京市科技计划课题(D161100000816005)。

摘　　要：目的探讨纤维乳管镜在病理性乳头溢液治疗中的应用价值。方法回顾性分析2019年1月至2020年12月于北京市通州区妇幼保健院行纤维乳管镜检查的431例病理性乳头溢液患者的临床资料,对乳管炎及乳管扩张患者进行灌洗治疗,电话随访观察其疗效;观察溢液的颜色及性状、单/多孔溢液、溢液量、溢液的侧别(单侧/双侧)等因素在良性病变与乳腺癌、占位性病变与非占位性病变、良性占位性病变(导管内乳头状瘤、癌前病变、其他良性病变和乳管炎及乳管扩张)患者间的差异。结果257例乳管炎及乳管扩张患者中共200例经冲洗治疗溢液量明显减少或者消失,总有效率为77.8%;良性病变和乳腺癌、占位性病变和非占位性病变的溢液颜色和性状比较,差异有统计学意义(P<0.05);良性病变和乳腺癌在单/多孔溢液上比较,差异有统计学意义(P<0.05),在溢液量上比较,差异无统计学意义(P>0.05);良性病变在单/多孔溢液上比较,差异无统计学意义(P>0.05),在溢液量上比较,差异有统计学意义(P<0.05);占位性病变和非占位性病变的单/多孔溢液和溢液量比较,差异有统计学意义(P<0.05)。结论纤维乳管镜能够诊断病理性乳头溢液的病因,对乳管内炎症性病变进行灌洗治疗起到良好的治疗效果,通过纤维乳管镜准确定位对乳管内占位性病变手术治疗,能够准确切除病灶,避免了手术的盲目性。Objective To explore the application value of fiberoptic ductoscopy in the treatment of pathological nipple discharge.Methods The clinical data of 431 patients with pathological nipple discharge who underwent fiberoptic ductoscopy in Tongzhou Maternal and Child Health Hospital of Beijing from January 2019 to December 2020 were analyzed retrospectively,patients with mammary duct inflammation and ductal ectasia were treated with breast duct lavage therapy,the curative effect was observed by telephone follow-up;the differences in color and character of discharge,single/porous nipple discharge,discharge volume,side of discharge(unilateral/bilateral)were observed in benign lesions and breast cancer,space occupying lesions and non-space-occupying lesions,benign space occupying lesions(intraductal papilloma,precancerous lesions,other benign diseases,mammary duct inflammation and ductal ectasia).Results In 257 patients with mammary duct inflammation and ductal ectasia,200 patients had significant reduction or disappearance of discharge volume after breast duct lavage therapy,and the total effective rate was 77.8%,the color and character between benign lesions and breast cancer,space occupying lesions and non-space-occupying lesions were compared,the differences were statistically significant(P<0.05),the benign lesions and breast cancer in single/porous discharge were compared,the differences were statistically significant(P<0.05),and the the discharge volume compared,the difference was not statistically significant(P>0.05).In benign space occupying lesions,in single/porous discharge were compared,the difference was not statistically significant(P>0.05),the discharge volume compared,the difference was statistically significant(P<0.05),the space occupying lesions and non-space-occupying lesions in single/porous discharge and discharge volume were compared,the differences were statistically significant(P<0.05).Conclusion Fiberoptic ductoscopy can diagnose the etiology of pathological nipple discharge and achieve good effica

关 键 词：纤维乳管镜 乳头溢液 定位 不典型增生 导管内癌 

分 类 号：R655[医药卫生—外科学]