超声定位结合亚甲蓝染色在切除乳腺不可触及钙化灶中的临床应用  

Clinical Application of Ultrasound Localization Combined with Methylene Blue Staining in the Resection of Non-palpable Breast Calcification Lesions

作　　者：杨硕 郭满 张浩 YANG Shuo;GUO Man;ZHANG Hao(Department of Postgraduate,Xinxiang Medical University,Xinxiang(453003),China)

机构地区：[1]新乡医学院研究生院,河南新乡453003

出　　处：《中国中西医结合外科杂志》2022年第5期623-627,共5页Chinese Journal of Surgery of Integrated Traditional and Western Medicine

基　　金：河南省科技攻关计划项目(202102310096)。

摘　　要：目的:比较超声引导下亚甲蓝定位法(USMBL)与钼靶导丝定位法(MWL)在乳腺不可触及钙化灶(NPBCL)活检中的临床应用价值。方法:选择2019年11月—2021年3月南阳市中心医院乳腺外科收治的77例患有乳腺可疑钙化灶的女性患者为研究对象。所有入组患者均为乳腺触诊未明确发现病变,但彩超钼靶均提示可疑钙化病变。其中USMBL组47例,MWL组30例,比较两组患者的手术切除体积指标、一次性完整切除成功率、切除病灶病理结果、病灶切除时间、手术并发症及术后满意度。结果:两种方法均能将病灶完整切除,USMBL组一次性完整切除的成功率为97.88%,高于MWL组83.33%(25/30),差异有统计学意义(P<0.05)。USMBL组总切除体积为(22.81±14.32)cm^(3),计算切除率为1.17±0.35,均小于MWL组的总切除体积(31.23±15.73)cm^(3)和计算切除率1.58±0.42,差异有统计学意义(P<0.05)。USMBL组病灶切除时间为(12.23±3.02)min,短于MWL组(15.93±4.68)min,差异有统计学意义(P<0.05)。USMBL组手术并发症发生率为6.38%,低于MWL组23.33%,差异有统计学意义(P<0.05)。USMBL组术后满意度为95.74%,高于MWL组73.33%,差异有统计学意义(P<0.05)。结论:USMBL比NPBCL定位更加准确、一次性切除率高、手术切除病灶时间短、手术并发症发生率低、切除正常乳房组织少,术后乳房外形改变小,患者满意度高。相较于昂贵的导丝定位法,亚甲蓝定位价格更低,有利于节省医疗资源,减轻患者负担,值得临床推广应用。Objective To compare the clinical application value of ultrasound-guided methylene blue localization(USMBL)and mammography-guided wire localization(MWL)in non-palpable breast calcification lesions(NPBCL).Methods A total of 77 female patients with suspected calcification in the breast were selected from the Department of Breast and Thyroid Surgery of Nanyang Central Hospital from November 2019 to March 2021.All enrolled patients had no clear lesions on breast palpation,but ultrasound and mammography suggested suspicious calcification.According to the localization method,47 cases were divided into the USMBL group and 30 cases were into the MWL group.Surgical resection volume,success rate of complete one-time resection,pathological results of lesions,resection time,incidence of surgical complications and satisfaction rate of postoperative were compared between the two groups.Results The lesions were resected completely by both methods.The success rate of one-time complete resection in the USMBL group was 97.88%(46/47),which was higher than that in the MWL group 83.33%(25/30)(P<0.05).The total resection volume(22.81±14.32)cm^(3)and calculated resection rate(1.17±0.35)in USMBL group were lower than those in MWL group(31.23±15.73)cm^(3)and(1.58±0.42).The time of lesion resection in USMBL group(12.23±3.02)min was shorter than that in MWL group(15.93±4.68)min.The incidence of operative complications in USMBL group(6.38%)was lower than that in MWL group(23.33%).The postoperative satisfaction in USMBL group(95.74%)was higher than that in MWL group(73.33%)(P<0.05).Conclusion USMBL has the advantages of more accurate localization of NPBCL,high one-time resection rate,short time for surgical resection of lesions,low incidence of operative complications,less resection of normal breast tissue and high satisfaction with patients with small breast appearance after operation.At the same time,compared with the expensive guide wire localization,methylene blue localization price is lower,which is conducive to saving medical res

关 键 词：乳腺可疑钙化灶 彩超 亚甲蓝定位 不可触及肿块 

分 类 号：R655.8[医药卫生—外科学]