熊秋云　王忆丽　雷秋模　范小庆　付飞国

【摘要】 目的：探讨超声引导下麦默通真空辅助旋切系统在临床触诊阴性乳腺病灶中的应用价值。方法：分析本院217例经超声检查发现的临床触诊阴性乳腺肿块患者的临床资料，按照手术方式不同分为麦默通组和传统开放手术组，比较两组手术情况、病理结果及预后随访情况。结果：217例患者的301枚病灶被准确完整切除，获得术后病理信息，3～6个月随访两组均未发生肿块复发情况。麦默通组手术时间、术后第1天疼痛视觉模拟评分（VAS）、术后乳房形态的改变及患者满意度均优于传统开放手术组（P<0.05）。麦默通组存在更多的乳腺内血肿、乳房皮下瘀斑等风险，但风险可控，即使发生也可通过简单处理即可痊愈，术后切口感染麦默通组0例，传统开放手术组1例。结论：麦默通真空辅助旋切系统治疗超声发现的临床触诊阴性乳腺肿块安全、有效、微创、美观，能够切除乳腺临床触诊阴性乳腺病灶，对早期乳腺癌的诊断具有重要的价值。

【关键词】 麦默通真空辅助旋切系统； 乳腺肿块； 临床触诊阴性； 术后并发症

Application Value Analysis of Mammotome Vacuum Assisted Biopsy System in the Treatment of Nonpalpable Breast Masses/XIONG Qiu-yun，WANG Yi-li，LEI Qiu-mo，et al.//Medical Innovation of China，2017，14（27）：034-037

【Abstract】 Objective：To evaluate the application value of ultrasound-guided Mammotome vacuum-assisted biopsy system in nonpalpable breast lesions.Method：The clinical data of 217 cases of clinically palpable negative breast masses detected by ultrasonography were analyzed，according to the operation were divided into Mammotome group and traditional open surgery group，compared two groups of surgery，pathology and prognosis.Result：301 lesions in 217 patients were completely resected，and postoperative pathological information was obtained，the patients were followed up for 3 to 6 months，no recurrence of the tumor occurred in the two groups.The operation time，postoperative first days visual analogue scale（VAS），postoperative breast shape change and patient satisfaction of Mammotome group were better than those of the traditional open surgery group（P<0.05）.There were more breast hematoma，breast ecchymosis and other risks in Mammotome group，but the risks were controllable，even if there were also available through simple treatment can be cured，Mammotome group incision infection in 0 case，1 case of traditional open surgery group.Conclusion：Mammotome vacuum assisted biopsy system in the treatment of the ultrasound findings of nonpalpable breast masses is safe，effective，minimally invasive，beautiful，able to remove breast nonpalpable breast lesions，has important value for the diagnosis of early breast cancer.

【Key words】 Mammotome vacuum-assisted biopsy system； Breast mass； Clinical palpation negative；Postoperative complications

First-authors address：The Third Hospital of Nanchang City，Nanchang 330009，China

doi：10.3969/j.issn.1674-4985.2017.27.010

临床触诊阴性乳腺肿块（nonpalpable breast lesion，NPBL）是指在临床工作中通过彩超、钼钯或磁共振发现，而临床的体格检查不可触及的肿块。临床触诊阴性的原因包括：病灶小、乳腺腺体厚且病灶较深，医生触摸时感觉不到；病灶质地与正常乳腺组织相似，边界触诊不清；乳腺多发增生结节，容易干扰医生手诊的判断[1]。临床上尤其常见彩超发现的NPBL，这些肿块直径大多数≤1 cm，且依据彩超结果很难评价良、恶性，需要手术切除活检或空芯针活检来明确其性质。传统开放手术（traditional open surger，TOS）存在定位困难、切口大等缺点，近年来国内兴起的乳腺麦默通真空辅助活检系统在诊治NPBL存在较大优势[2-3]。本研究分析本院2013年1月-2016年6月收治217例触诊阴性乳腺腫块患者的临床资料及预后信息，初步探讨超声引导下麦默通真空辅助旋切系统在临床触诊阴性乳腺肿块中的应用及价值，现报道如下。……