微創旋切技術治療多發乳腺小結節的臨床研究

廖樺　方志紅　陳龍林

【摘要】 目的：探討微創旋切技術治療多發乳腺小結節的應用效果。方法：選取2015年7月-2018年6月本院收治多發乳腺小結節患者250例，按不同外科手術方式分為微創手術（minimally invasive surgery，MIS）組和開放手術（conventional open excision，COE）組，每組125例。MIS組給予微創旋切技術治療，COE組給予開放手術治療。比較兩組手術時間、術中出血量、拔管時間、切口愈合時間、乳房美容效果、術后6個月復發率及并發癥發生率。結果：MIS組手術時間、術中出血量、拔管時間、切口愈合時間及術后6個月并發癥發生率均明顯低于COE組（P<0.05）。MIS組乳房美容效果優良率明顯高于COE組（P<0.05）。兩組術后6個月復發率比較，差異無統計學意義（字2=0.044，P>0.05）。結論：與開放手術相比，微創旋切技術治療多發乳腺小結節具有明顯優勢。

【關鍵詞】 微創旋切技術; 乳腺小結節; 多發性; 乳腺疾病

Clinical Study of Minimally Invasive Rotary Cutting Technique in the Treatment of Multiple Breast Small Nodules/LIAO Hua，FANG Zhihong，CHEN Longlin.//Medical Innovation of China，2019，16（18）：-114

【Abstract】 Objective：To explore the application effect of minimally invasive rotary cutting technique in the treatment of multiple breast small nodules.Method：250 patients with multiple breast small nodules admitted to our hospital from July 2015 to June 2018 were selected.They were divided into minimally invasive surgery（MIS）group and open surgery（COE）group according to different surgical methods，125 cases in each group.The MIS group was treated with minimally invasive rotary cutting technique，while the COE group was treated with open surgery.The operation time，intraoperative blood loss，extubation time，incision healing time，breast cosmetic effect，recurrence rate and complication rate 6 months after surgery of the two groups were compared.Result：The operation time，intraoperative blood loss，extubation time，incision healing time and the incidence of complications 6 months after surgery in the MIS group were significantly lower than those in the COE group（P<0.05）.The excellent rate of breast cosmetic effect in the MIS group was significantly higher than that in the COE group（P<0.05）.There was no significant difference in recurrence rate 6 months after surgery between the two groups（P>0.05）.Conclusion：Compared with open surgery，minimally invasive rotary cutting technique has obvious advantages in the treatment of multiple small breast nodules.

【Key words】 Minimally invasive rotary cutting technique; Breast small nodules; Multiple; Breast diseases

First-authors address：Dafeng Hospital of Chaoyang District，Shantou 515154，China

doi：10.3969/j.issn.1674-4985.2019.18.029

開放手術治療多發乳腺小結節的手術入路主要有環乳暈切口、雙環乳暈切口、弧形切口及放射狀切口，此類手術入路的切口長度長及愈合后瘢痕明顯，破壞了乳房表面皮膚的完整和外觀[1-4]。同時，開放手術治療多發乳腺小結節要通過上述手術入路構建皮下隧道來剔除病灶，在構建皮下隧道時不可避免對乳房的結構造成明顯損傷，以至于手術后造成乳房毀形[5-6]。

隨著人文環境的改變，女性對乳房保健和乳房美學的重視程度加深，人們對普外科治療多發乳腺小結節的微創醫學和美學效果提出了更高要求[7-10]。開放手術已經無法滿足人們對微創醫學和美學效果方面提出的新要求[11-14]。近期，本院采用微創旋切技術治療多發乳腺小結節獲得良好療效，本著為微創旋切技術治療多發乳腺小結節提供參考和依據的目的，將本研究患者的臨床資料分析、總結?，F報道如下。