乳晕边缘切口及压力封闭残腔技术在乳腺良性肿块切除术中的应用(1)
[摘要] 目的 探讨在乳腺良性肿块切除术中应用乳晕边缘切口及压力封闭残腔技术的疗效。方法 方便选取80例于2013年4月—2014年4月期间在该院行局部手术的乳腺良性肿块患者，根据残腔处理的不同分为缝闭腺体残腔组(A组)和压力封闭残腔组(B组)，均行乳腺良性肿块切除术，观察两组临床疗效、满意度、乳房外形变化率及术后1、2 d时VAS评分情况。结果 两组切口愈合率差异无统计学意义，但B组满意度较A组显著要高(P<0.05)，分别为97.5%、82.5%，而乳房外形变化率显著低于A组(P<0.05)，分别为2.5%、15.0%；同时两组术后1、2 d时VAS评分比较差异无统计学意义(P>0.05)，术后3 d时B组VAS评分显著低于A组(P<0.05)，分别为(2.13±0.35)分、(2.62±0.39)分，差异均有统计学意义。结论 在乳腺良性肿块切除术中应用乳晕边缘切口及压力封闭残腔技术可取得显著疗效，具有推广价值。
[关键词] 压力封闭残腔技术；乳晕边缘切口；乳腺良性肿块切除术
[中图分类号] R73 [文献标识码] A [文章编号] 1674-0742(2016)09(a)-0086-03
[Abstract] Objective To study the clinical effect of periareolar incision and pressure closure of residual cavity technology in the resection of benign breast lump. Methods Convenient selection 80 patients with benign breast lump treated from April 2013 to April 2014 in our hospital were divided into two groups according to the different processing method of residual cavity.GroupA adopted the sewing of residual cavity；Group B adopted the pressure closure of residual cavity. The benign breast lump was resected. The clinical effect， satisfaction， breast shape and VAS point after 1 d and 2 d of surgery for two groups was observed. Results The healing rate of the incision for two groups was not significantly different；the satisfaction of Group B (97.5%) was higher than that of Group A(82.5%)(P<0.05)；the bad rate of breast shape for Group B (2.5%) was lower than that of Group A (15.0%) (P<0.05)；After 1 d and 2 d of surgery，the VAS point for two groups was not significantly different (P>0.05)； after 3 d of surgery，the VAS point for Group B and Group A was (2.13±0.35)poimts and (2.62±0.39)poimts(P<0.05).Conclusion During the resection of benign breast lump， the periareolar incision and pressure closure of residual cavity technology has an obvious effect in clinical practice. It is worthy of promotion.
[Key words] Pressure closure of residual cavity； The edge of the areola incision； Benign breast tumor resection
目前治疗乳腺良性肿块，切口多位于肿块位置，能完整切除肿块，但术后疤痕明显，严重影响乳房美观。经乳晕入路切除肿块不会损伤乳腺功能，可维持乳房形态。切除肿块后形成残腔，目前临床对残腔的处理尚存在争议[1]。该文于2013年4月—2014年4月期间对40例乳腺良性肿块患者采取乳晕边缘切口及压力封闭残腔技术治疗，探讨其临床疗效，以期为临床治疗提供依据，现报道如下。
1 资料与方法
1.1 一般资料
方便选取80例在该院行局部手术的乳腺良性肿块患者，术前均行彩超检查，40岁以上者行钼靶，术中冰冻为恶性者排除，肿块于乳腺各象限分布，其中乳腺增生囊肿9例，乳腺纤维腺瘤65例，积乳囊肿3例，乳管内乳头状瘤1例，乳腺巨纤维腺瘤2例。根据残腔处理的不同分为缝闭腺体残腔组(A组)和压力封闭残腔组(B组)，组内均有40例。A组中，患者年龄18～53岁，平均(30.53±2.46)岁，直径0.42～6.38 cm，平均(2.28±0.86) cm，B组中，患者年龄19～55岁，平均(30.56±2.41)岁，直径0.45～6.40 cm，平均(2.31±0.85)cm。两组乳腺良性肿块患者在年龄、肿块直径等资料上差异无统计学意义(P>0.05)，具有可比性。 (闫建平 连红霞 李秀刚)
[关键词] 压力封闭残腔技术；乳晕边缘切口；乳腺良性肿块切除术
[中图分类号] R73 [文献标识码] A [文章编号] 1674-0742(2016)09(a)-0086-03
[Abstract] Objective To study the clinical effect of periareolar incision and pressure closure of residual cavity technology in the resection of benign breast lump. Methods Convenient selection 80 patients with benign breast lump treated from April 2013 to April 2014 in our hospital were divided into two groups according to the different processing method of residual cavity.GroupA adopted the sewing of residual cavity；Group B adopted the pressure closure of residual cavity. The benign breast lump was resected. The clinical effect， satisfaction， breast shape and VAS point after 1 d and 2 d of surgery for two groups was observed. Results The healing rate of the incision for two groups was not significantly different；the satisfaction of Group B (97.5%) was higher than that of Group A(82.5%)(P<0.05)；the bad rate of breast shape for Group B (2.5%) was lower than that of Group A (15.0%) (P<0.05)；After 1 d and 2 d of surgery，the VAS point for two groups was not significantly different (P>0.05)； after 3 d of surgery，the VAS point for Group B and Group A was (2.13±0.35)poimts and (2.62±0.39)poimts(P<0.05).Conclusion During the resection of benign breast lump， the periareolar incision and pressure closure of residual cavity technology has an obvious effect in clinical practice. It is worthy of promotion.
[Key words] Pressure closure of residual cavity； The edge of the areola incision； Benign breast tumor resection
目前治疗乳腺良性肿块，切口多位于肿块位置，能完整切除肿块，但术后疤痕明显，严重影响乳房美观。经乳晕入路切除肿块不会损伤乳腺功能，可维持乳房形态。切除肿块后形成残腔，目前临床对残腔的处理尚存在争议[1]。该文于2013年4月—2014年4月期间对40例乳腺良性肿块患者采取乳晕边缘切口及压力封闭残腔技术治疗，探讨其临床疗效，以期为临床治疗提供依据，现报道如下。
1 资料与方法
1.1 一般资料
方便选取80例在该院行局部手术的乳腺良性肿块患者，术前均行彩超检查，40岁以上者行钼靶，术中冰冻为恶性者排除，肿块于乳腺各象限分布，其中乳腺增生囊肿9例，乳腺纤维腺瘤65例，积乳囊肿3例，乳管内乳头状瘤1例，乳腺巨纤维腺瘤2例。根据残腔处理的不同分为缝闭腺体残腔组(A组)和压力封闭残腔组(B组)，组内均有40例。A组中，患者年龄18～53岁，平均(30.53±2.46)岁，直径0.42～6.38 cm，平均(2.28±0.86) cm，B组中，患者年龄19～55岁，平均(30.56±2.41)岁，直径0.45～6.40 cm，平均(2.31±0.85)cm。两组乳腺良性肿块患者在年龄、肿块直径等资料上差异无统计学意义(P>0.05)，具有可比性。 (闫建平 连红霞 李秀刚)