中国综合临床
中國綜閤臨床
중국종합림상
CLINICAL MEDICINE OF CHINA
2014年
7期
686-689
,共4页
王懋莉%丁昂%殷初阳%宋晖%孙太明%张征%陈宏亮%金玉春%傅少梅%王富文%孙建
王懋莉%丁昂%慇初暘%宋暉%孫太明%張徵%陳宏亮%金玉春%傅少梅%王富文%孫建
왕무리%정앙%은초양%송휘%손태명%장정%진굉량%금옥춘%부소매%왕부문%손건
乳腺肿块%Mammotome 手术%乳腺后间隙入路%乳腺肿块旁入路
乳腺腫塊%Mammotome 手術%乳腺後間隙入路%乳腺腫塊徬入路
유선종괴%Mammotome 수술%유선후간극입로%유선종괴방입로
Breast lump%Mammotome%Retromammary space approach%Breast masses side approach
目的：探讨经乳腺后间隙入路 Mammotome 微创手术行乳腺肿块活检的临床价值。方法将2011年1月至2012年5月在我院乳腺科行 Mammotome 微创手术的787例患者应用计算机随机分为两组，行乳腺后间隙入路 Mammotome 微创手术385例，乳腺肿块旁入路402例。术后常规随访，分别比较两组患者的手术效果及并发症情况。结果术后随访12个月，乳腺后间隙入路组和肿块旁入路组手术时间分别为（48±6）min 和（52±4）min，肿瘤切除率分别为99.48％（383/385）和99.25％（399/402），组间比较差异无统计学意义（P 均＞0.05）；两组术中出血量分别为（8±3）ml 和（14±6） ml，术后皮下瘀斑发生率分别为2.34％（9/385）和8.71％（35/402），残腔血肿发生率分别为0.52％（2/385）和2.74％（11/402），切口数量分别为（1.3±0.6）个和（2.4±0.3）个，组间比较差异均有统计学意义（P =0.033，P =0.000，P =0.001，P =0.006），两组患者满意率分别为98.70％（380/385）和89.30％（359/402），乳腺后间隙入路组高于肿块旁入路组，组间比较差异有统计学意义（ P =0.004）。结论乳腺后间隙入路 Mammotome 微创活检乳腺肿块较常规乳腺肿块旁入路微创手术方式出血性并发症少，美观效果更佳，有一定的优势。
目的：探討經乳腺後間隙入路 Mammotome 微創手術行乳腺腫塊活檢的臨床價值。方法將2011年1月至2012年5月在我院乳腺科行 Mammotome 微創手術的787例患者應用計算機隨機分為兩組，行乳腺後間隙入路 Mammotome 微創手術385例，乳腺腫塊徬入路402例。術後常規隨訪，分彆比較兩組患者的手術效果及併髮癥情況。結果術後隨訪12箇月，乳腺後間隙入路組和腫塊徬入路組手術時間分彆為（48±6）min 和（52±4）min，腫瘤切除率分彆為99.48％（383/385）和99.25％（399/402），組間比較差異無統計學意義（P 均＞0.05）；兩組術中齣血量分彆為（8±3）ml 和（14±6） ml，術後皮下瘀斑髮生率分彆為2.34％（9/385）和8.71％（35/402），殘腔血腫髮生率分彆為0.52％（2/385）和2.74％（11/402），切口數量分彆為（1.3±0.6）箇和（2.4±0.3）箇，組間比較差異均有統計學意義（P =0.033，P =0.000，P =0.001，P =0.006），兩組患者滿意率分彆為98.70％（380/385）和89.30％（359/402），乳腺後間隙入路組高于腫塊徬入路組，組間比較差異有統計學意義（ P =0.004）。結論乳腺後間隙入路 Mammotome 微創活檢乳腺腫塊較常規乳腺腫塊徬入路微創手術方式齣血性併髮癥少，美觀效果更佳，有一定的優勢。
목적：탐토경유선후간극입로 Mammotome 미창수술행유선종괴활검적림상개치。방법장2011년1월지2012년5월재아원유선과행 Mammotome 미창수술적787례환자응용계산궤수궤분위량조，행유선후간극입로 Mammotome 미창수술385례，유선종괴방입로402례。술후상규수방，분별비교량조환자적수술효과급병발증정황。결과술후수방12개월，유선후간극입로조화종괴방입로조수술시간분별위（48±6）min 화（52±4）min，종류절제솔분별위99.48％（383/385）화99.25％（399/402），조간비교차이무통계학의의（P 균＞0.05）；량조술중출혈량분별위（8±3）ml 화（14±6） ml，술후피하어반발생솔분별위2.34％（9/385）화8.71％（35/402），잔강혈종발생솔분별위0.52％（2/385）화2.74％（11/402），절구수량분별위（1.3±0.6）개화（2.4±0.3）개，조간비교차이균유통계학의의（P =0.033，P =0.000，P =0.001，P =0.006），량조환자만의솔분별위98.70％（380/385）화89.30％（359/402），유선후간극입로조고우종괴방입로조，조간비교차이유통계학의의（ P =0.004）。결론유선후간극입로 Mammotome 미창활검유선종괴교상규유선종괴방입로미창수술방식출혈성병발증소，미관효과경가，유일정적우세。
Objective To evaluate the effect of ultrasound-guided vacuum-assisted minimal invasive resection(Mammotome procedure)of breast lumps through the retromammary space. Methods Seven hundred and eighty-seven patients in Obstetrics and Gynecology Hospital Affiliated to Fudan University from Jan. 2011 to May 2012 were underwent ultrasound-guided Mammotome operation through the retromammary space (retromammary space group,385 cases),or adjacent the lumps,and followed by post-operation visits regularly (Mammotome operation adjacent the lumps group,402 cases). The operation effects were compared between the two groups. Results All cases were followed up for 12 months. The period of Mmmotome operation through the retromam mary space and the rate of resection were(48 ± 6)min and(52 ± 4)min,99. 48%(383 / 385), 99. 25%(399 / 402),perspectively,in group of Mammotome operation through the retromammary space and Mammotome operation adjacent lumpsand. There was no significant difference between the two groups( P> 0. 05). The amount of procedural bleeding,the incidence of ecchymosis,local hematoma and the number of incision in group of Mammotome operation through the retromammary space were(8 ± 3)ml,2. 34%(9 / 385), 0. 52%(2 / 385),(1. 3 ± 0. 6)respectively,which were significantly lower than those in Mammotome operation adjacent the lumps group((14 ± 6)ml,8. 71%(35 / 402),2. 74%(11 / 402),(2. 4 ± 0. 3)respectively). There were statistical difference between two groups( P = 0. 003,P < 0. 001,P = 0. 001,P = 0. 006). The rate of satisfaction in group of Mammotome operation through the retro-mammary space was 98. 70%(380 / 385),which is significantly higher than in group of Mammotome operation adjacent the lumps(89. 30%(359 / 402),P< 0. 01). Conclusion The therapy approach of ultrasound-guided Mammotome operation through the retromammary space has lower hemorrhagic complication,as well as the better effect with special advantages. Therefore it has prospective clinical application.
