超声引导下麦默通微创切除乳腺良性肿块78例剖析.docVIP

超声引导下麦默通微创切除乳腺良性肿块78例剖析 　　【摘要】 目的 探讨超声引导下麦默通微创切除乳腺良性肿块的临床应用要点。 方法 78例女性患者共81个乳腺肿物,在超声引导下行麦默通微创切除术,病理检查明确性质,术后3~6个月随访治疗效果。结果 81个乳腺肿块中,良性肿块79个,乳腺癌灶2个,术中显示肿块均完整切除,单个肿块切除平均时间10 min。3例出现术后血肿情况。术后3~6个月随访,78例中76例效果满意,满意率达97.44%,术后随诊6月暂未发现复发情况。结论 麦默通微创切除乳腺良性肿块具有安全、微创,效果确切、术后美观的优点,以5~25 mm肿块效果最佳,而对30 mm的肿块效果欠佳。 　　【关键词】 超声引导,麦默通;乳腺良性肿块? 　　【Abstract】 Objective To explore the clinicle application main points of benign breast mass using minimally invasive treatment of high frequency ultrasound guided Mammotome.Methods 81 tumor of 78 gynopatients underwent minimally invasive treatment of high frequency ultrasound guided Mammotome, the property of masses were identified by pathology and the gyno-patients were followed up after 3 months to 6 months later of operation.Results There were 79 benign breast mass and 2 breast cancer in 81 tumours.Ultrasound showed that all the tumours were completely removed with Mammotome.The patients were followed up after treatment, and the satisfaction rate was 97.44% (76/78).There 3 cases hematomaed after the surgery. Zero case relapsed during 6 months (0/78).Conclusion High frequency ultrasound guided Mammotome is a minimally invasive, safe and accurate technique which does not influence the appearance of breast.It is especially suitable for 5~25 mm masses, but not suitable for benign breast mass which is bigger than 30 mm. 　　【Key words】 Ultrasonography, Mammotome; Benign breast mass 　　 　　作者单位:519000中山大学附属第五医院 　　 　　麦默通微创旋切系统用于乳腺微创活检,同时其特殊的空负压吸引装置和旋切系统可施行微创切除术。它对于细的乳房病变的诊断及治疗是一有效的工具[1],可提高术前乳房病变的诊断率[2]。我院从2008年6月至2009年6月,对78例乳腺结节施行B超引导下行麦默通微创旋切术,现总结如下。 　　1 资料和方法 　　1.1 一般资料 本组78例均为女性患者,年龄21~53岁,平均(37.0±2.0)岁。因乳房胀痛、乳头溢液或体检来诊,乳腺可扪及肿块63例,大小约10~35 mm,乳腺内未扪及肿块15例,未扪及肿块者为超声检查发现乳腺5~10 mm,实质内微小钙化灶(不包括乳腺脂肪层)而于门诊或入院治疗。其中75例为单侧,左侧40例,右侧35例;3例为双侧。23例为乳腺小肿块合并微小钙化,15例未见明显肿块。基于目前尚未将微创旋切作为乳腺恶性肿瘤的切除手段考虑,本研究所选择病例均是术前超声检查提示肿块形态规则、边界清楚、后方不伴明显声衰减,内部无明显血流信号且同侧腋下未探及可疑恶性淋巴结的患者。钙化点直径均0.1 cm,两粒至多粒成簇不等,位置各异,位于外上象限者居多。 　　1.2 主要仪器 美国强生公司麦默通乳腺微创旋切系统(Vaccum?Assisted Ma