超声引导下微创旋切联合小切口手术在乳腺巨纤维腺瘤治疗中的应用研究-现代医学

超声引导下微创旋切联合小切口手术在乳腺巨纤维腺瘤治疗中的应用研究

单位：南京医科大学附属淮安第一医院甲乳外科, 江苏淮安 223300

分类号：R655.8

出版年·卷·期（页码）：2020·48·第十二期（1559-1563）

摘要：

目的： 探讨超声引导下微创旋切联合小切口手术在乳腺巨纤维腺瘤治疗中的可行性和安全性。方法： 回顾性分析我院收治的78例乳腺巨纤维腺瘤患者，其中38例患者采用传统开放手术治疗（传统组），另外40例患者采用微创旋切联合小切口手术治疗（微创组）。通过查阅病历资料、回访患者等方式，比较两组患者手术时间、手术切口长度、术中出血量、住院时间、术后满意度、随访满意度等方面的差异。结果： 微创组手术时间较传统组更长，切口长度较传统组更短，差异有统计学意义（P<0.01），但两组在术中出血量、住院时间等方面差异均无统计学意义。术后半年随访两组查彩超均无术后复发。微创组术后手术疤痕明显率12.5%，乳房外形满意率87.5%，患者满意值94.13；传统组术后手术疤痕明显率63.2%，乳房外形满意率55.3%，患者满意值83.58。两组间3项指标比较，差异均具有统计学意义（均P<0.05）。结论： 与传统开放手术比较，超声引导下微创旋切联合小切口手术在乳腺巨纤维腺瘤治疗中具有创伤及手术疤痕小、术后恢复快、乳房外形影响小、患者满意度高等优势，能更好地提高患者术后生活质量且手术安全性较高，值得推广。

Objective: To explore the feasibility and safety of minimal size of incision combined with ultrasound-guided vacuum-assisted breast biopsy using Encor biopsy system in the treatment of giant breast fibroadenoma. Methods: Clinical data of 78 patients with giant benign tumor of breast operated in our hospital from 2017 to 2019 were analyzed retrospectively. The patients were divided into Encor group (n=40) and traditional group according to different operations (n=38). Significant heterogeneity was detected between two groups for the following factors:incision length, operation time, postoperative complication, scar and breast morphology satisfaction rate. Results: The Encor group had longer operation time but shorter incision than those in traditional group, the differences were statistically significant. There was no recurrence of nodes in either of the group at 6 months follow-up. In Encor group, postoperative satisfaction rate of surgical scar and breast appearance were higher than those of traditional group, and patients expressed higher overall satisfaction rate in Encor group. Conclusion: Consideringfactors of surgical scar, postoperative recovery, breast appearance, patient satisfaction, minimal size of incision combined with ultrasound-guided vacuum-assisted breast biopsy using Encor biopsy system for treatment of giant breast fibroadenoma showed superiority in all above areas.

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