乳管内窥镜在诊治非肿瘤性乳头溢液中的应用

Mammary ductoscopy in the diagnosis and treatment of nontumoural nipple discharge

目的探讨乳管内窥镜及介入治疗法诊治积乳症、闭塞性乳管炎及导管扩张症。方法选取本院2003年3月至2008年3月乳管镜诊断为乳腺疾病患者7426例,年龄25～74岁,平均36.8岁,全部为女性。根据镜下表现分组:积乳症组(2466例)、闭塞性乳管炎组(2026例)及导管扩张症组(2934例),3组均给予介入治疗,3～4周为1个疗程。随访3～36个月。结果7426例患者中,总治愈率为62.59%(4648/7426),总有效率为93.33%(6931/7426)。积乳症组有效率达96.15%,治愈率达72.91%;闭塞性乳管炎组有效率达90.57%,治愈率达53.95%;导管扩张症组有效率达92.88%,治愈率达59.88%。并发症:乳管皲裂25例,细菌感染13例,血肿3例,未发现医源性感染。结论乳管内窥镜对积乳症、闭塞性乳管炎及导管扩张症具有特异性诊断作用。乳管内窥镜介入治疗直接有效。

Objective To explore the clinical value of mammary ductoscopy in the diagnosis and treatment of adenosis of breast. Methods From March 2003 to March 2008, 7426 patients were diagnosed as adenosis of breast by mammary ductoscopy in our hospital. Their age ranged from 25 - 74 years, with the mean of 36. 8 years. All patients were female. According to mammary ductoscopic appearance, the patients were divided into a latex accumulation disease group（ n= 2466 cases）, a closed galactophoritis group （n= 2026 cases ） and a ductal ectasia group （n = 2934 cases）. All the 3 groups were given mammary ductoscopy interventional therapy, 3--4 weeks as one therapy course. All patients were followed up for 3--36 months. Results In the 7426 patients, the overall cure rate was 62.59% （4648/7426 cases）, and the total effective rate was 93. 33% （6931/7426 cases）. The cure rate and effective rate were 72. 91% and 96. 15% in the latex accumulation disease group, and 53.95% and 90. 57% in the closed galactophoritis group, and 59.88% and 92. 88% in the ductal ectasia group, respectively. Complications included mammary duct chap in 25 cases, bacterium infection in 13 cases, and haematoma in 3 cases, no nosocomial infection was found. Conclusion Mammary ductoscopy has specific diagnosis for disease of latex accumulation, ductal ectasia and closed galactophoritis. Mammary ductoscopy interventional therapy is direct and effective.