环乳晕切口切除乳腺纤维腺瘤临床探究.doc

环乳晕切口切除乳腺纤维腺瘤临床探究[摘要]目的：环乳晕切口切除乳腺纤维腺瘤(fibroadenoma ectomy by circum-areola incision, FECAI)因为有突出的美学优势，已经在国内多家医疗单位应用。但是，发表的文献并没有详细阐明FECAI的适应证、禁忌证、注意事项和并发症的预防等问题。因而，本文针对这些问题进行较为详尽的研究和阐述。方法:研究组（35例，40侧乳房）进行了FECAI；同时期同一医疗组所做的肿块表面切口纤维腺瘤切除术设为对照组（28例，32侧乳房）。回顾分析方法比较两组在手术时间、出血量等方面的差别，并且阐述适应证等问题。结果:手术时间：研究组(49±8)min；对照组(38±5)min（P＞0.05）。出血量：研究组(20±5)ml；对照组(31±6)ml（P0.05）。适应证：乳晕直径3.5～5.0cm；肿块外缘距离最近乳晕边缘小于5.0cm；肿块直径3.0cm以下；体检、B超、钼靶、细针穿刺或空心针穿刺等所有术前检查均支持纤维腺瘤的诊断。禁忌证：肿块直径大于5.0cm；肿块外缘距离最近乳晕边缘距离≥6.0cm；有恶性可能。结论：此种切口设计的突出优点是瘢痕隐蔽，美容优势明显。为减少并发症的出现，必须掌握好适应证和禁忌证。 [关键词]乳晕；切口；纤维腺瘤 [中图分类号]R622[文献标识码]A[文章编号]1008-6455（2009）02-0147-03 A clinical study on the resection of breast fibroadenoma by circum-areolaincision LIU Xiao-feng，ZHOU Qian, CHEN Fei, MA Jing-jing, ZHANG Min,YIN Hong, DA Ying-xiang, XIE Hui, LU Cheng (Breast Centre Department,Nanjing Maternal and Child Health Hospital Affiliated to Nanjing Medical University, Nanjing 210004,Jiangsu,China) Abstract:ObjectiveFibroadenoma ectomy by circum-areola incision(FECAI)have been applied in many domestic clinical centers for its notable advantage with excellent cosmetic results. Unfortunately, indications, contraindications, surgical procedures and cautious notes as well as complications prevention about FECAI have not been described in published literature in details. Therefore, this article gave a discussion in these aspects. MethodsThe authors present indications, contraindications, surgical procedures and cautious notes as well as complicatios prevention in details about FECAI by retrospectively analysised 35 patients with 40 breasts fibroadenoma (experimental group) who underwentFECAI and 28 patients with 32 breasts fibroadenoma (control group)who underwent fibroadenoma ectomy with the incision on the surface of mass by the same surgeon teams in the same period. Difference of bleeding volume, operation time between two groups was compared.ResultsOperation time of experimental group was (49±8) minutes（P＞0.05）；the contr