|本期目录/Table of Contents|

[1]王力,肖献秋,芮小平.超声引导下EnCor乳腺微创手术不同操作方法的临床应用[J].医学研究与战创伤救治(原医学研究生学报),2020,22(6):612-616.[doi:10.3969/j.issn.1672-271X.2020.06.012]
　WANG Li,XIAO Xian-qiu,RUI Xiao-ping.Clinical application of ultrasound-guided EnCor breast system in breast masses of different operations[J].JOURNAL OF MEDICALRESEARCH —COMBAT TRAUMA CARE,2020,22(6):612-616.[doi:10.3969/j.issn.1672-271X.2020.06.012]
点击复制

超声引导下EnCor乳腺微创手术不同操作方法的临床应用()
分享到62.8K

《医学研究与战创伤救治》（原医学研究生学报）[ISSN:1672-271X/CN:32-1713/R]

卷:
第22卷
期数:
2020年6期
页码:
612-616
栏目:
临床研究
出版日期:
2020-11-20

文章信息/Info

Title:
Clinical application of ultrasound-guided EnCor breast system in breast masses of different operations
作者:
王力; 肖献秋; 芮小平
作者单位：214044无锡，解放军联勤保障部队第九○四医院甲乳外科（王力、肖献秋、芮小平）
Author(s):
WANG Li; XIAO Xian-qiu; RUI Xiao-ping
（Department of Breast and Thyroid Surgery, the 904th Hospital of the Joint Logistics Support Force，PLA，Wuxi 214044,Jiangsu，China）
关键词:
EnCor乳腺微创旋切术; 超声探头定位; 旋切刀头操作; 肿块残留; 皮肤误切
Keywords:
EnCor breast minimally invasive rotary surgery;  ultrasonic probe positioning;  biopsy probe operating approach; residual masses; skin dimpling
分类号:
R737.9
DOI:
10.3969/j.issn.1672-271X.2020.06.012
文献标志码:
A
摘要:
目的探讨超声引导下EnCor乳腺微创手术中超声探头定位与旋切刀头不同的操作方法的临床应用价值。方法回顾性分析2016年2月至2019年7月期间解放军联勤保障部队第九○四医院甲乳外科就诊的279例（包括乳房良性肿块女性患者276例及乳腺增生男性患者3例）接受超声引导下EnCor乳腺微创旋切手术患者的临床资料，分别分析比较超声探头采用平移法185例和十字定位法94例进行术中肿块定位，EnCor旋切刀头采用侧入法169例和正后入路法110例进行手术旋切操作之间的临床疗效。结果279例均成功完成手术，术中发生皮肤误切导致凹陷、破损12例；因术中出血压迫止血无效转为开放手术2例；术后3个月复查发现肿块部分残留14例；术后24 h内出现血肿9例，所有血肿均在1.5个月内吸收消失。术后均无感染发生、无明显的乳房变形及瘢痕形成。术后常规病理示乳腺腺病伴纤维腺瘤262例，脂肪瘤14例，男性乳腺腺体增生3例。超声探头采用平移法出现肿块残留率[2.16%（4/185）]低于十字定位法[10.60%（10/94）]，差异有统计学意义（P＜0.05）；其他并发症发生率比较差异均无统计学意义（P>0.05）。EnCor旋切刀头侧入法出现皮肤误切导致凹陷、破损发生率[1.18%（2/169）]低于正后路入法[9.09%（10/110）]，差异有明显统计学意义（P＜0.01）；其他并发症发生率比较差异均无统计学意义（P>0.05）。结论EnCor乳腺微创旋切手术中超声探头采取平移法操作，旋切刀头采取侧入法操作，有定位准确、肿块切除完整、术中操作安全、乳房无变形等优点，在微创手术操作中是较好的选择，显示出微创手术的优势和价值。
Abstract:
ObjectiveTo investigate the application value of ultrasound-guided EnCor system with different operations of the ultrasonic probe and EnCor biopsy probe.MethodsA retrospective cohort study of 279 patients (276 female breast benign masses and 3 gynecomastia patients) received ultrasound-guided EnCor system surgical operation was admitted between February 2016 and July 2019 in department of breast and thyroid of 904 hospital of PLA Joint Logistics Support Force. A randomized clinical trial on the curative effect of 185 translations constantly and 94 cross-shape positioning of ultrasonic probe，the EnCor biopsy probe operational approach of 169 posterior and 110 right astern were evaluated.ResultsThe physical condition of 279 patients were evaluated good preoperative and operated successfully. The skin of 12 patients were incidental excised lead to skin dimpling or damaged intraoperative; 2 patient was converted to open rhinoplasty approach caused by blood soss intraoperative which hemostasis by compression unsuccessfully;Partial residual masses of 14 cases was reviewed 3 month postoperation; Postoperative hemorrhage was found in 9 patients and disappeared within 1.5 months. All cases were completed without infection，obvious breast deformation and scar formation. Postoperative convention pathology showed 262 cases of breast adenosis or fibroadenoma, 3 cases of gynecomastia, and 14 of lipomyoma. Within the translation constantly and Cross-shape positioning of ultrasonic probe, the partial residual masses incidence rate of translation[2.16%（4/185）] was lower than that of cross-shape positioning[10.60%（10/94）], which had statistically significance(P＜0.05); the incidence of other complications had not much distance（P＞0.05）; The skin dimpling or damaged intraoperative of incidence rate of EnCor biopsy probe operational approach of posterior[1.18%（2/169）] was lower than that of right astern[9.09%（10/110）].There was statistically significant（P＜0.01），and no significance between other complications.ConclusionTo the EnCor minimally invasive breast surgery, it has the advantage of positioning accuracy，mass excision exhaustive，intraoperative operating safety and maintaining the normal shape of the breast, with the posterior approach of EnCor biopsy probe and translation constantly positioning of the ultrasonic probe. This better option may magnify the advantages and value of minimally invasive surgery.

参考文献/References:

[1]阮华,刘异,王跃振.乳腺纤维腺瘤患者中医体质特征研究[J].浙江中西医结合杂志,2018,28(9):760-763.
[2]郑兰兰.超声引导下微创旋切活检系统对于乳腺疾病诊疗优势评价[J].现代医用影像学,2017,26(5):1423-1425.
[3]骆礼波,刘道生,洪伟, 等.安珂微创旋切术治疗急性哺乳期乳腺炎伴脓肿形成46例疗效观察[J].贵州医药,2015,(11):1005-1006.
[4]张海燕,万航宇,王品, 等.微创旋切加引流与开放切除病灶治疗肉芽肿性乳腺炎对照研究[J].中国普外基础与临床杂志,2019,26(1):67-71.
[5]顾军,于泽平,王少华, 等.麦默通微创活检系统对乳腺肿块诊断的应用价值[J].医学研究生学报,2010,23(3):279-281.
[6]丁国乾,高银光,葛智成, 等.超声引导下麦默通微创旋切术在1036例乳腺肿块切除中的应用[J].临床和实验医学杂志,2019,18(12):1309-1312.
[7]陈桂林,黎润尧,高学忠, 等.乳晕边缘切口在青年女性乳腺良性肿块手术中的应用效果[J].中国现代药物应用,2019,13(8):56-57.
[8]许志平,宋彬,姜子荣.麦默通乳腺微创旋切手术与开放手术治疗乳腺良性肿块的疗效观察[J].中国社区医师（医学专业）,2012,14(31):114-115.
[9]Order BM, Schaefer PJ, Peters G, et al. Evaluation of two different vacuum-assisted breast biopsy systems: Mammotome(R) system 11G/8G vs. ATEC(R) system 12G/9G[J]. Acta Radiol, 2013, 54(2):137-143.
[10]胡薇,樊佳裔,张庆萍, 等.不同浓度肾上腺素对麦默通微创旋切术后血肿的预防作用[J].中华乳腺病杂志（电子版）,2011,5(2):222-224.
[11]高学忠.Mammotome微创活检系统诊治乳腺病灶临床分析[J].广西医学，2009,31(2):214-215.
[12]高学忠,王西悦,张蓉, 等.麦默通扇形推进法旋切较大良性乳腺肿块的可行性研究[J].中华乳腺病杂志（电子版）,2011,5(1):35-40.
[13]陈旭,龚旭初.超声引导下Mammotome微创旋切系统切除乳房肿块应用体会[J].蛇志,2015,(2):217-218.
[14]苏静,朱秀玲,李金英.6例糖尿病性乳腺病的超声图像分析并文献复习[J].东南国防医药,2016,18(2):192-193.
[15]Maxwell AJ . Ultrasound-guided vacuum-assisted excision of breast papillomas: review of 6-years experience[J]. Clin Radiol, 2009, 64(8):801-806.
[16]陈烁,杨斌,魏淑萍.超声引导下自动活检术对乳腺肿瘤的诊断价值[J].医学研究生学报,2011,24(9):930-933.

相似文献/References:

备注/Memo

备注/Memo:
-
更新日期/Last Update: 2020-12-01