三维超声在乳腺良性疾病微创诊疗并发症防治中的应用

The application of three-dimensional ultrasonography in prevention and treatment of complications in minimally invasive excision of benign breast diseases

目的探讨三维超声引导下VACORA真空辅助系统用于乳腺良性疾病诊疗并发症的防治效果。方法选取324例于术前拟诊断为良性病灶的586个肿块经三维容积成像,随机分成经二维超声引导组(176例)及经实时三维引导组(148例)两组,对两组患者的肿块容积和术后血肿的发生情况与血肿体积大小、血肿的吸收时间和皮肤瘀斑的发生情况进行观察和比较。结果全部肿块均成功引导切除,术后血肿发生率三维引导组少于二维引导组,两组间有显著性差异(P<0.05),而且不同容积大小的血肿在吸收率方面还存在差异。全部发生血肿病例5个月均吸收完全。结论三维超声引导乳腺良性肿块的微创切除,定位准确,安全,损伤小,并且能减少术后主要并发症的发生,且能准确定量血肿体积,是乳腺肿块微创切除的一种有效引导方法。

Objective To investigate the effects of VACORA vacuum-assisted rotation system guided by three-dimen- sional ultrasonography in prevention and treatment of the complications of benign breast diseases. Methods All of 324 cases which had 586 masses by three-dimensional volumetric imaging in the preoperative diagnosis of benign lesions were randomLy divided into two-dimensional （2-D） ultrasonography guidance group （176 cases） and real-time three- dimensional （3-D） ultrasonography guidance group （148 cases）,then the volume of the mass, the incidence of post- operative hematoma and volume,the hematoma absorbtion time,the occurrence of skin bruising were compared be- tween two groups. Results All the masses were excised successfully ,the incidence of hematoma post-operative in 3-D group was less than that in 2-D group, which had significant difference between two groups （P 〈 0.05）, there was also had significant difference in absorption rate of the hematoma in different volumes. All cases with hematoma were ab- sorbed completely in 5 months. Conclusion Minimal invasive excision of benign breast masses guided by 3-D ultra- sonography may not only have the advantage of positioning accuracy, safety and less damage,but also can reduce the incidence of major complications after surgery and accurately quantify the hematoma volume,it is an effective method in minimal invasive excision of breast mass.