摘要
目的探讨钼靶引导下单钩术前定位针定位在乳腺无肿块钙化病灶区段切除活检中的应用价值。方法40例经影像学钼靶X线发现钙化灶、体格检查无明显肿块的患者,按随机数字表法分为对照组和研究组,各20例。对照组术前根据钼靶X线所示位置于皮肤表面标记钙化体表投影位置,局部麻醉下切除钙化灶体表投影周围区段组织;研究组术前24 h内于钼靶X线下采用单钩术前定位针穿刺定位,局部麻醉下切除包含导丝在内的周围小区段组织。比较两组手术切除标本重量、手术时间、住院时间、视觉模拟评分法(VAS)评分、术后病理检出结果、病灶定位准确率、并发症发生率。结果术后3 d,研究组VAS评分(0.61±0.34)分低于对照组的(1.12±0.45)分,差异具有统计学意义(P<0.05);研究组手术切除标本重量(42.56±6.72)g小于对照组的(74.13±9.49)g,手术时间(27.39±2.51)min及住院时间(4.61±0.35)d短于对照组的(35.78±3.45)min、(6.43±0.74)d,差异具有统计学意义(P<0.05)。两组纤维腺瘤、导管内乳头状瘤、乳腺腺病、浸润性癌、原位癌病理检出率比较,差异无统计学意义(P>0.05)。研究组病灶定位准确率95.00%高于对照组的70.00%,差异具有统计学意义(P<0.05);两组并发症发生率比较,差异无统计学意义(P>0.05)。结论钼靶引导下单钩术前定位针定位用于乳腺无肿块钙化病灶区段切除活检患者中,可减轻患者疼痛,缩短手术及住院时间,且病灶定位准确率较高,值得推广应用。
Objective To discuss the application value of mammography-guided preoperative singlehook-wire localization for segmental excisional biopsy of calcified lesions in the breast without masses.Methods A total of 40 patients who found calcified lesions by mammography and no obvious mass in physical examination were divided into control group and study group according to the random numerical table,with 20 cases in each group.In the control group,the location of the calcified body projection was marked on the skin surface according to the position shown on the mammography,and the tissue around the body projection of the calcified foci was excised under local anesthesia;in the study group,a single-hook-wire localization needle was used to puncture the area under the mammography within 24 h before surgery,and the surrounding small area including the guidewire was excised under local anesthesia.The weight of surgical specimen,operative time,length of hospital stay,visual analogue scale(VAS)score,postoperative pathological detection results,lesion localization accuracy and complication rate were compared between the two groups.Results At 3 d postoperatively,the VAS score of the study group was(0.61±0.34)points,which was lower than that of(1.12±0.45)points of the control group,and the difference was statistically significant(P<0.05).The weight of surgical specimen of(42.56±6.72)g in the study group was smaller than that of(74.13±9.49)g in the control group;the operative time of(27.39±2.51)min and the length of hospital stay of(4.61±0.35)d in the study group were shorter than those of(35.78±3.45)min and(6.43±0.74)d in the control group;the differences were statistically significant(P<0.05).There was no statistically significant difference in the pathological detection rates of fibronenoma,intraductal papilloma,breast adenosis,invasive carcinoma and carcinoma in situ between the two groups(P>0.05).The lesion localization accuracy of the study group was 95.00%,which was higher than that of 70.00%of the control group,and the difference was statistically significant(P<0.05).There was no statistically significant difference in the incidence of complications between the two groups(P>0.05).Conclusion In patients with segmental excisional biopsy of calcified lesions without masses in the breast,mammography-guided preoperative single-hook-wire localization can reduce patient pain,shorten operative time and length of hospital stay with high lesion localization accuracy,which is worthy of promotion and application.
作者
陈凯旋
黄兴伟
孙聪玲
李荣
CHEN Kai-xuan;HUANG Xing-wei;SUN Cong-ling(Ganzhou Cancer Hospital,Ganzhou 341000,China)
出处
《中国现代药物应用》
2023年第17期84-87,共4页
Chinese Journal of Modern Drug Application
基金
计划类别:乙类(项目编号:2020-1-07)。
关键词
乳腺癌
钼靶引导
单钩术前定位
乳腺无肿块钙化病灶
切除活检
Breast cancer
Mammography-guided
Preoperative single-hook-wire positioning
Calcified lesions in the breast without masses
Excisional biopsy
