超声引导下乳腺小肿物术前定位.docVIP

超声引导下乳腺小肿物术前定位【摘要】 目的 探讨临床上不可触及的乳腺小肿块术前超声引导下穿刺定位的意义。方法 在超声引导下对30例临床上不能触及的乳腺肿块用定位针术前定位。结果 30个临床不能触及的乳腺肿块,术前在超声引导下定位针定位后行外科手术,全部被准确切除,其中3例为(10%)为恶性肿瘤。结论 临床上不能触及的乳腺肿块术前行超声引导定位是简单而准确的方法,节省了手术时间,组织损伤小,并发症少,减轻患者痛苦。乳腺癌可以在早期被发现。 【关键词】 超声引导;乳腺肿物;定位针 Preoperative localization ofsmall breast lesion guided by ultrasonography ZHANG Yu-rong,KANG Ying-hui, MAN Da,et al. Department of Function, The People’s Hospital of Hulunbeier City, Inner Mongolia Hulunbeier021008,China 【Abstract】 Objective To explore the value of the located needles guided by ultrasound to locate breast lesions, which were unclear in clinical palpation. Methods Pre-operative localization was performed using wire needle by ultrasonography in 30 non-palpable breast lesion of 30 women. Results Thirty non-palpable breast lesions were excised radically after pre-operation localization guided by ultrasonography. Three (10%) of these lesions were m alignant. Conclusion Preoperative localization guided by ultrasonography appear to be a simple method for non-palpable breast lesions. It will save the time of operation ,lessen the injury, and at the same, decrease the ratio of complication. The breast cancers could be found by located needles areat small size and at early stage. 【Key words】 Ultrasound guidance; Breast lesion; Located needle 乳腺肿瘤是女性的最常见疾病之一,近年有逐渐上升的趋势。本研究用定位针在超声引导下对临床不能触及的乳腺肿块行术前定位,为切除肿块提供准确的定位并依病理结果制定相应的手术方案。 1 资料和方法 1.1 临床资料 2009年3月至2009年12月,临床体检不能触及而高频超声下发现的微小肿物共30个(30例患者),均为女性,年龄26~55岁,平均40岁。超声测量肿块大小,最小0.6 cm×0.5 cm,最大1.2 cm×0.9 cm。 1.2 仪器和方法 1.2.1 仪器 使用PHILIP-IU22彩色多普勒超声诊断仪,探头频率7~10 L。能实时显示针尖位置和其进入肿块的途径。并根据具体情况调整深度、增益、聚焦部位,使图像达到最佳。定位针选用美国普诺麦斯生产的专用乳腺定位针。 1.3 方法 定位于手术当天进行。视肿块位置嘱患者采取适当体位,碘伏消毒皮肤,铺无菌巾,高频浅表探头用无菌素料膜包裹,皮肤上涂无菌耦合剂或生理盐水作导声,探头扫查到肿块后,显示肿块最长径线,测量肿块距体表距离后,在肿块最长径线位置固定探头,并使肿块位于近探头一端的下方,超声实时引导下将定位针斜行刺入病灶,推出定位导丝,缓慢退出定位针鞘。将定位导丝尾端过长的部分剪掉,留下5~6 cm,无菌纱布覆盖固定。而后立刻将患者送至手术室,与定位时相同体位下进行手术,术后被切除的肿物送冰冻病理。若为良性病变,手术完毕,缝合创口;若为恶性,可根据具体情况改变手术方式或扩大手术范围。 2 结果 30例患者的30个肿块定位准确率为100