乳头溢液326例临床研究.doc

乳头溢液326例临床研究[摘 要] 目的 探讨乳头溢液的病因和诊断方法。方法 对1996年11月～2007年10月我院收治326例乳头溢液病人临床资料进行回顾性分析。结果 326例乳头溢液病人中，106例血性，65例浆液血性，103例为浆液性，23例乳汁性，14例脓性，15例水性。病理切片证实，154例导管内乳头状病，81例乳腺增生，39例导管扩张，32例乳腺癌，20例乳腺炎。结论 乳头溢液的性质对乳腺疾病的诊断具有重要意义，乳头溢液以良性乳腺病为最常见90.2% (294／326)，乳腺癌少见9.8% (32/326)。45岁以上患者乳癌可能性明显增加。 关键词：乳头溢液 病因 乳腺病 Clinical analysis of 326 cases of nipple discharge [Abstract] Objective To investigate the causes，diagnosis and treatment of nipple discharge. Methods The clinical data of 326 cases of nipple discharge treated in our hospital from November 1996 to October 2007 were retrospectively analysis.Results Three hundred and twenty-six patients with nipple discharge，106 of them were bleeding discharge,65 of them were serosanguinous discharge,103 of them were serous discharge, 23 of them were milk discharge，14 of them were purulent discharge，and 15 of them were watery discharge.Diagnosis of etiology confirmed that 81 patients were caused by pathological breast hyperplasia，154 patients were caused by intraductal papilla，39by duct ectasia ,32 by breast cancer and 20 by mastitis.Conclusion The characters of nipple discharge have an important significance in the diagnosis and diferential diagnosis of the mammary diseases.Benign etiology is the cause in 90.2% (294／326)，and breast cancer only in 9.8% (32/326).The possibility of breast carcinoma increased obviously in patient over 45 years of age. [Key words] nipple discharge etiology breast disease 中图分类号：R711 文献标示码：B 文章编号：1005-0019（2008）3-0005-02 乳头溢液是乳腺疾病的常见和重要症状之一，其所占比例仅次于乳腺肿块和乳腺疼痛，发生率为3%～8%，也是某些疾病的早期诊断依据之一，明确其性质具有重要的意义。现将我院收治的乳头溢液326例分析报告如下。 1 资料与方法 1.1 一般资料 自1996年11月2007年10月，我院收治乳头溢液患者326例。女318例，男8例。年龄20～76岁，平均43.2岁。溢液持续时间最短2天，最长3.5年，平均4.2个月。单导管溢液262例，双侧或多导管溢液64例；合并乳腺肿块189例，其中伴有单个肿物163例，多个肿物26例；肿物位于乳晕内67例，乳晕外122例。伴有乳头内陷57例；同侧腋窝淋巴结肿大16例。 1.2 溢液性质 血性106例，浆液血性65例，浆液性103例，乳汁性23例，脓性14例，水性15例。 1.3 诊断治疗方法 本组行溢液涂片310例，B超检查235例，X线钼靶照相215例、乳腺导管造影225例，乳腺内窥镜检查65例。 2 结果 326例乳头溢液中，经x线钼靶照相可见乳腺内肿物189例，砂粒样钙化3