真空辅助乳腺微创旋切术治疗乳腺良性肿瘤的效果  

Application of vacuum-assisted minimally invasive breast gyrotomy in the treatment of benign breast tumors

作　　者：张银维 应光璐 卢舟燕 ZHANG Yin-wei;YING Guang-lu;LU Zhou-yan(Department of Breast Surgery,Zhoushan Women's and Children's Hospital,Zhoushan,Zhejiang 316000,China)

机构地区：[1]舟山市妇女儿童医院乳腺外科,浙江舟山316000

出　　处：《中国妇幼保健》2023年第13期2501-2505,共5页Maternal and Child Health Care of China

基　　金：浙江省舟山市科技计划项目(2018C31121)。

摘　　要：目的探究真空辅助乳腺微创旋切术在乳腺良性肿瘤中的应用效果。方法回顾性分析2019年10月—2020年10月在舟山市妇女儿童医院接受手术治疗的100例乳腺良性肿瘤患者的资料,依据术式的不同分为对照组(40例)和观察组(60例)。对照组行传统开放手术,观察组在B超引导下行真空辅助乳腺微创旋切术。统计两组围术期各指标情况,比较术前、术后3 d两组患者视觉模拟疼痛评分(VAS)、疼痛因子、炎症细胞因子以及应激反应指标水平的差异性,并评价手术的安全性。结果观察组手术用时、切口愈合、住院时间、瘢痕长度、术中出血量分别为(20.11±6.34)min、(4.17±1.75)d、(6.60±2.34)d、(2.80±0.65)mm及(4.55±1.60)ml,对照组分别为(32.00±8.45)min、(7.25±2.78)d、(10.36±2.22)d、(24.08±5.90)mm及(10.11±2.78)ml,观察组上述指标均较对照组更低,差异均有统计学意义(t=8.030、6.803、8.033、27.576、12.677,均P<0.05)。术后1、3、5、7 d观察组的VAS评分分别为(5.67±0.70)分、(4.28±1.00)分、(3.09±0.43)分、(1.20±0.11)分,对照组则为(7.00±1.23)分、(5.55±1.56)分、(4.34±0.56)分、(2.30±0.23)分,观察组术后1、3、5、7 d观察组的VAS评分均较对照组更低(t=6.879、4.965、12.602、32.013,均P<0.05)。术后3 d,观察组神经肽Y(NPY)、5-羟色胺(5-HT)以及前列腺素E2(PGE2)水平分别为(130.00±12.78)ng/L、(184.34±15.09)ng/L、(270.44±26.32)ng/L,均较对照组的(139.89±14.85)ng/L、(198.00±17.63)ng/L、(292.19±28.74)ng/L更低,差异均有统计学意义(t=3.552、4.144、3.902,均P<0.05)。术后3 d,观察组IL-10、INF-γ及CRP水平分别为(16.90±3.21)pg/ml、(2678.89±609.66)ng/ml、(16.00±3.23)mg/L,对照组IL-10、INF-γ及CRP水平分别为(21.88±5.00)pg/ml、(2209.78±753.10)ng/ml、(31.56±5.90)mg/L,观察组IL-10、CRP均低于对照组,其INF-γ高于对照组(t=6.070、16.988、3.428,均P<0.05)。术后3 d,观察组Cor、E以及NE水平分别为(105.09±15.34)mmol/L、Objective To explore the application effect of vacuum-assisted minimally invasive breast gyrotomy in benign breast tumors.Methods Retrospective analysis was performed on the data of 100 patients with benign breast tumor who received surgical treatment in our hospital from October 2019 to October 2020,and they were divided into control group(40 cases)and observation group(60 cases)according to different surgical methods.The control group received traditional open surgery,and the observation group received vacuum-assisted minimally invasive breast rotorectomy under the guidance of B-ultrasound.The perioperative indexes of the two groups were statistically analyzed,and the differences of visual analog pain scale(VAS),pain factors,inflammatory factors and stress response indexes were compared between the two groups before surgery and 3 days after surgery,and the safety of surgery was evaluated.Results In the observation group,the operation time,incision healing,length of hospital stay,scar length and intraoperative bleeding were(20.11±6.34)min,(4.17±1.75)d,(6.60±2.34)d,(2.80±0.65)mm,(4.55±1.60)ml.The control group was(32.00±8.45)min,(7.25±2.78)d,(10.36±2.22)d,(24.08±5.90)mm,(10.11±2.78)ml.The above indexes in the observation group were lower than those in the control group(t=8.030,6.803,8.033,27.576,12.677,P<0.05).The VAS scores of the observation group were(5.67±0.70)points,(4.28±1.00)points,(3.09±0.43)points and(1.20±0.11)points on day 1,3,5 and 7 after surgery.And the control group were(7.00±1.23)points,(5.55±1.56)points,(4.34±0.56)points and(2.30±0.23)points.The VAS score of the observation group was lower than that of the control group at 1,3,5 and 7 days after operation(t=6.879,4.965,12.602,32.013,P<0.05).3 days after operation,the levels of NPY,5-HT and PGE2 in the observation group were(130.00±12.78)ng/L,(184.34±15.09)ng/L and(270.44±26.32)ng/L.The levels of(139.89±14.85)ng/L,(198.00±17.63)ng/L and(292.19±28.74)ng/L were lower than those in the control group(t=3.552,4.144,3.902,P<0.05)

关 键 词：乳腺良性肿瘤 真空辅助乳腺微创旋切系统 微创 乳腺肿物传统切除 效果 

分 类 号：R737.9[医药卫生—肿瘤]