天津医药

天津医药 ›› 2016, Vol. 44 ›› Issue (4): 385-388.doi: 10.11958/20160021

• 专题研究-乳腺肿瘤 •    下一篇

麦默通在乳腺良性肿块治疗中的应用研究

王健， 张丽娜， 顾林△   

  1. 天津医科大学肿瘤医院乳腺二科， 国家肿瘤临床医学研究中心， 乳腺癌防治教育部重点实验室， 天津市 “肿瘤防治” 重点实验室（邮编300060）
  • 收稿日期:2016-01-20 修回日期:2016-02-11 出版日期:2016-04-15 发布日期:2016-05-20
  • 通讯作者: △通讯作者 E-mail： gulindr@yahoo.com E-mail:gulindr@yahoo.com
  • 作者简介:王健 （1981）， 男， 主治医师， 硕士研究生在读， 主要从事乳腺癌临床与基础研究； 现工作单位为天津市第五中心医院
  • 基金资助:
    国家自然科学基金面上项目 （81202275）； 天津市自然科学基金资助项目 （13JCQNJC11000）

Clinic study of mammotome minimally invasive operation in the treatment of benign breast lumps

WANG Jian, ZHANG Lina, GU Lin△   

  1. The Second Department of Breast Cancer, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin Key Laboratory of Breast Cancer Prevention and Therapy, Tianjin Medical University, Tianjin 300060, China
  • Received:2016-01-20 Revised:2016-02-11 Published:2016-04-15 Online:2016-05-20
  • Contact: △Corresponding Author E-mail： gulindr@yahoo.com E-mail:gulindr@yahoo.com
  • Supported by:
    Project of the National Natural Science Foundation of China

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摘要： 摘要： 目的 探讨麦默通在乳房良性肿块切除中的应用价值及造成肿块残留的影响因素。方法 722 例乳腺良性肿块患者经麦默通治疗， 记录术中皮肤切口长度、 旋切次数、 出血量及手术时间。分析术后并发症构成， 比较肿块残留在不同乳腺影像报告和数据系统 （BI-RADS） 分级、 病灶数目及肿块大小等临床特征中的构成差异。Logistic 回归分析肿块残留的影响因素。结果 722例患者的平均皮肤切口平均长度 （6.25±1.92） mm、 平均旋切 （11.62±4.28） 次、平均出血量 （6.22±2.08） mL； 切除组织条直径 2.0~3.5 mm， 平均长 （13.69±5.06） mm； 单个肿块平均切除时间 （7.85± 2.91） min。发生疼痛、 局部红肿、 淤青及血肿并发症者共 33 例 （4.57%）， 以疼痛 （32 例） 和淤青 （26 例） 为主。肿瘤肿块共 1 367 枚， 以乳腺纤维腺瘤 683 枚 （49.96%） 为主。13 例 （1.59%） 患者有肿块残留， 肿块残留比例随病灶数目的增多而增加、 肿块＞2 cm 者高于肿块≤2 cm 者、 肿块边界不清者高于清晰者； 有血肿、 淤青形成者高于无血肿、 淤青形成者 （P＜0.01）。肿块＞2 cm、 肿块边界不清晰、 多发性肿块及有血肿形成为肿瘤残留的独立危险因素。结论 麦默通微创旋切术治疗乳腺良性肿块安全有效。术前应综合评估肿块数目、 大小及边界情况， 以降低肿块残留风险。

关键词: 乳腺疾病, 外科手术, 微创性, 危险因素, 麦默通

Abstract: Abstract： Objective To investigate the clinical application of mammotome minimally invasive techniques for benign breast mass, and the risk factors of residual tumor. Methods A total number of 722 patients with benign breast mass re⁃ ceived treatment of mammotome minimally invasive operation. Skin incision length, peeling times, blood loss and operation time were recorded. The complications after surgery, the difference of constitution ratio in different BI-RADS grades, mass number, mass volume and clinic features were analysed. The Logistic repression analysis was used to analyze risk factors of mass residue. Results The average skin incision length was (6.25±1.92) mm in 722 patients, with an average peeling times of (11.62±4.28) and average blood loss of (6.22±2.08) mL. The average diameter of removed tissue was 2.0-3.5 mm with an average length of (13.69±5.06) mm. An average operation time for single mass was (7.85±2.91) min. Complications were mainly pain (n=32) and bruising (n=26) in 33 patients (4.57%). A total of 1 367 breast lumps were found in 722 patients, in which there were 683 fibroadenoma (49.96%). Thirteen patients (1.59%) were found mass residue during follow-up. The pro⁃ portion of mass residue was increased with the increased number of mass, and was higher in mass diameter above 2 cm than in diameter less 2 cm, and also higher in tumor without clear boundary group than that with clear boundary group, and higher in patients with hematoma and bruising than that without hematoma and bruising. Mass diameter > 2 cm, no clear boundary, multiple tumors and hematoma formation were independent risk factors of mass residue. Conclusion The mammotome minimally invasive operation is a safe and potent therapeutic management for benign breast mass. Comprehensive evaluation of the tumor size, tumor boundary, the number of mass before operation can reduce the risk of mass residue.

Key words: breast diseases, surgical procedures, minimally invasive, risk factor, mammotome biopsy system