CAJ | 학술논문

目的：全面系统比对B超引导下的Mammotome微创旋切除术和传统开放式手术治疗乳腺不可触及病灶的效果和安全性。方法选择2009年2月~2014年3月于广州军区总医院乳腺外科接受治疗的300例女性患者共388处不可触及病灶或肿块为研究对象，分为两组，其中，观察组255例患者共333处乳腺不可触及病灶施行B超引导下的Mammotome微创旋切术，同期对照组45例患者共55处乳腺肿块施行传统开放式手术。术后1个月随访，术后3个月行彩超复查。整个过程观察并记录手术结果、病理结果和随访结果。所得数据采用统计学软件SPSS 17.0进行分析处理。结果观察组患者的切口长度、术中出血量、愈合时间、术后瘢痕大小和乳房变形现象均明显优于对照组，差异有统计学意义(P<0.05)；观察组和对照组患者的术后满意度分别为94.1%和40.0%，差异有统计学意义(P<0.05)。结论 B超引导下Mammotome微创旋切术不但诊断灵敏度高、专属性强，且疗效理想、操作简便，具有创伤小、安全性高的显著优势，临床上可作为治疗乳腺不可触及病灶的首选方案。
목적：전면계통비대B초인도하적Mammotome미창선절제술화전통개방식수술치료유선불가촉급병조적효과화안전성。방법선택2009년2월~2014년3월우엄주군구총의원유선외과접수치료적300례녀성환자공388처불가촉급병조혹종괴위연구대상，분위량조，기중，관찰조255례환자공333처유선불가촉급병조시행B초인도하적Mammotome미창선절술，동기대조조45례환자공55처유선종괴시행전통개방식수술。술후1개월수방，술후3개월행채초복사。정개과정관찰병기록수술결과、병리결과화수방결과。소득수거채용통계학연건SPSS 17.0진행분석처리。결과관찰조환자적절구장도、술중출혈량、유합시간、술후반흔대소화유방변형현상균명현우우대조조，차이유통계학의의(P<0.05)；관찰조화대조조환자적술후만의도분별위94.1%화40.0%，차이유통계학의의(P<0.05)。결론 B초인도하Mammotome미창선절술불단진단령민도고、전속성강，차료효이상、조작간편，구유창상소、안전성고적현저우세，림상상가작위치료유선불가촉급병조적수선방안。
Objective To comprehensively and systematically compare the efficacy and safety of B-ultrasound guide Mammotome minimally invasive resection and traditional open surgery in the treatment of nonpalpable breast lesion. Methods 300 cases of female patients with a total of 388 nonpalpable lesions or masses treated in Department of Breast Surgery, Guangzhou General Hospital of PLA from February 2009 to March 2014 were selected as the research objects, and divided into two groups. 255 patients with a total of 333 nonpalpable breast lesions in observation group were performed B-ultrasound guide Mammotome minimally invasive resection, synchronously 45 patients with a total of 55 nonpalpable breast lesions of control group were performed traditional open surgery. The patients were followed-up 1 month after operation and given color doppler ultrasound 3 months after operation. Surgical results, pathological examinations and follow-up results were observed and recorded in the whole process. The results were analyzed by the statistical software SPSS 17.0. Results The incision length, intraoperative blood loss, healing time, size of the scar and breast deformity of patients in the observation group were better than those patients in the control group, the differences were statistically significant (P< 0.05). The patients' postoperative satisfaction of observation group and control group were 94.1%and 40.0%respectively, the differences were statistically significant (P<0.05). Conclusion B-ultrasound guide Mammotome minimally invasive resection has high detection sensitivity, specificity, ideal curative effect and simple operation. It also has the significant advantages of light trauma and high safety, can be used as the preferred therapy for nonpalpable breast lesion in clinic.