乳管镜在多孔乳头溢液诊断及治疗中的应用价值

Application of Fiberoptic Ductoscopy in Diagnosing and Treating Multiple Ductal Nipple Discharge

目的:探讨乳管镜在双侧多孔乳头溢液诊断和治疗中的应用价值。方法:对29例双侧多孔乳头溢液患者进行乳管镜检查,发现乳管内肿瘤者给予手术治疗,对积乳症、乳管扩张症、闭塞性乳管炎患者给予经乳管镜介入治疗。结果:29例(79孔乳管)中,乳管内肿瘤者11例(乳管),占病例总数的(占所检乳管数)37.93%(13.92%),血性溢液11例中乳管内肿瘤9例,非血性溢液18例中乳管内肿瘤2例;切除病灶准确率100%,术后病理诊断符合率88.89%。结论:乳管镜检查有其直观性,术前定位准确,避免了手术的盲目性或切除范围过大;多数患者或乳管,尤其积乳症、闭塞性乳管炎及乳管扩张症的患者或乳管,经过经乳管镜冲洗及介入治疗可达到彻底治愈。

Objective： To explore the value of fiberoptic ductoscopy in diagnosing and treating bilateral muhiple ductal nipple discharge. Methods： Twenty-nine patients with bilateral, multiple duetal nipple discharge were examined by fiberoptic ductoscopy. Those patients with intraduetal papilloma were Ireated through surgery and those with galaelostasia, mammary ducteetasia and obstructive galactophoritis were treated by fiberoptic ductoscopy. Results： Of the 29 cases, there were 11 cases with intraductal papilloma （37.93%）. Of the 11 patients with bloody nipple discharge, 9 were diagnosed as intraduetal papilloma. Of the 18 patients with non- bloody nipple discharge, 2 were diagnosed as intraduetal papilloma. All lesions were resected and 88.89% of the preoperative diagnosis were consistent with the postoperative pathological diagnosis. Conclusion： Fiberoptic ductoscopy has many advantages such as direct-viewing and aecuracy. Mosl of the patients with galactostasia or mammary duct ectasia or obstructive galaetophoritis can be cured by fiberoptie duetoscopy.