李丽燕 吴金其 李金涛 刘卫新

[摘要]目的：探討非哺乳期乳腺肿块患者采用超声引导下麦默通、安珂微创旋切术的治疗效果。方法：对笔者医院2012年9月-2019年9月收治402例非哺乳期乳腺肿块患者相关资料予以回顾性分析，依据患者手术方式将接受超声引导下麦默通以及安珂旋切术患者分别纳入麦默通组（n=209，223个肿块）与安珂组（n=193，208个肿块）。比较两组患者符合术式标准肿块切除率、围手术期相关指标、术后并发症发生率及术后3个月超声复查肿块残留率。结果：麦默通组、安珂组符合术式标准肿块切除率分别为96.86%，99.52%，组间比较差异无统计学意义（P>0.05）。麦默通组手术持续时间、刀头更换频率均高于安珂组，差异有统计学意义（P<0.05）。两组间切口长度、术中失血量、手术切口愈合时间、术后疼痛持续时间比较差异无统计学意义（P>0.05）。麦默通组患者术后感染、乳房内部血肿发生率显著低于安珂组，差异有统计学意义（P<0.05）;而两组间皮下瘀斑发生率比较差异无统计学意义（P>0.05）。手术完成后3个月超声复查两组肿块残留率比较差异无统计学意义（1.44% vs 0.52%，P>0.05）。结论：非哺乳期乳腺肿块患者采用超声引导下麦默通、安珂微创旋切术进行治疗效果均显著，但安珂微创旋切术手术时间短，而麦默通微创旋切术术后并发症发生率较低，临床应用可以依据实际情况进行选择。

[关键词]超声;麦默通微创旋切术;安珂微创旋切术;非哺乳期乳腺肿块;疗效

[中图分类号]R737.9    [文献标志码]A    [文章编号]1008-6455（2021）04-0095-04

Comparison of Two Kinds of Ultrasound-guided Minimally Invasive Surgery in the Treatment of Non-lactation Breast Masses

LI Li-yan1，WU Jin-qi2，LI Jin-tao2，LIU Wei-xin2

（1.Department of Galactophore，Beijing Chaoyang Emergency Treatment Center of Traditional Chinese and Western Medicine，Beijing 100022，China;2.Department of Breast Surgery，Huanxing Ward，Cancer Hospital of Chinese Academy of Medical Sciences， Beijing 100122，China）

Abstract： Objective  To explore the curative effect of ultrasound-guided mammotome minimally invasive surgery and EnCor minimally invasive surgery on non-lactational breast masses. Methods  A retrospective analysis of related data of 402 patients with non-lactational breast masses who were admitted and treated in the hospital during the period from September 2012 to September 2019 was performed. Patients treated with ultrasound-guided mammotome minimally invasive surgery were included in the mammotome group （209 patients with 223 lumps） and those treated with EnCor minimally invasive surgery were included in the EnCor group （193 patients with 208 lumps）. The mass resection rate， perioperative related indicators， postoperative complications and residual rate of ultrasound reexamination 3 months after operation were compared between the two groups. Results  The mass resection rates according with operation indications in the mammotome group and yhe EnCor group were 96.86% and 99.52%， respectively. There was no significant difference between the two groups （P>0.05）. The duration of surgery and frequency of handpiece replacement in the mammotome group were longer/higher than those in the EnCor group， the differences were statistically significant （P<0.05）. Differences in incision length， intraoperative blood loss， healing time of the surgical incision or duration of postoperative pain between the two groups were not statistically significant （P>0.05）. The incidences of postoperative infection and intramammary hematoma in the mammotome group were significantly lower than those in the EnCor group （P<0.05）. But difference in the incidence of subcutaneous ecchymosis was not statistically significant （P>0.05）. Ultrasound reexamination results showed that difference in the rate of residual lump between the two groups in 3 months after surgery was not statistically significant （1.44% vs 0.52%， P>0.05）. Conclusion  Both ultrasound-guided mammotome minimally invasive surgery and EnCor minimally invasive surgery are markedly effective in treatment of non-lactational breast lump. However， the duration of EnCor minimally invasive surgery is shorter， and the incidence of complications after mammotome minimally invasive surgery is lower.

Key words： ultrasound-guided; mammotome minimally invasive surgery; EnCor minimally invasive surgery; non-lactational breast mass; curative effect

乳腺肿块类疾病为女性群体常见疾病，调查报告结果显示乳腺肿块疾病中有近4/5患者肿块性质为良性[1]。近期乳腺肿块发病率因为污染环境、生活工作压力以及食品安全等原因逐年上升，而相关影像技术逐渐成熟使其检出率逐渐增加[2]。传统手术……