微创旋切术与传统手术治疗乳腺良性肿块疗效、疼痛及患者预后的比较研究

Comparative study of curative efficacy, pain of patients and prognosis of minimally invasive biopsy system for excision and traditional surgery for benign breast mass

目的探讨比较微创旋切术与传统切除手术治疗乳腺良性肿块的疗效及预后。方法回顾性分析200例乳腺良性肿块患者临床资料,按手术方式分为对照组(n=98)和观察组(n=102)。对照组给予传统切除手术治疗,观察组给予微创旋切术治疗。观察比较两组肿块切除率、手术时间、术中出血量、切口长度、切口愈合时间等手术情况以及术后疼痛视觉模拟评分(VAS)、并发症发生率、复发情况、美容效果及患者满意度等。结果两组患者肿块切除率均为100%。与对照组相比,观察组术中出血量明显减少,手术时间、切口愈合时间及切口长度显著缩短,术后即刻、6、12及24 h的VAS评分均显著降低,差异均有统计学意义(均P<0.05)。并发症方面,观察组并发症总发生率为6.7%,明显低于对照组22.2%的发生率(P<0.05)。随访6个月,两组患者均无复发病例,观察组美容效果优良率高达99.0%,患者满意度高达92.2%,均显著高于对照组患者,均P<0.05。结论微创旋切术是治疗乳腺良性肿块的一种安全、可靠和美容的手术方式,能够有效切除肿块,复发率低,且切口小、术中出血量少、手术时间和切口愈合时间短,并能显著缓解术后疼痛,降低并发症发生率,且促进术后康复及美观,是符合该手术适应证患者的首选手术方式。

【Objective】To compare the curative efficacy, pain of patients and prognosis of minimally invasive biopsy system for excision and traditional surgery in the treatment of benign breast mass. 【Methods】Totally 200 cases of benign breast mass meeting the inclusion criteria were divided into control group（n = 98） and observation group（n = 102） according to the operation method. The control group was given traditional excision, and the observation group was given minimally invasive biopsy system for excision. Then, excision rate of mass, operation time,bleeding volume during operation, incision length, healing time, visual analogue score（VAS） after surgery, incidence of complications, recurrence rate of mass, cosmetic result and the satisfaction degree of the patients were observed and compared. 【Results】The excision rate of mass in both groups was 100.0%. In comparison with the control group, the observation group had statistically less bleeding, shorter operation time, healing time of incision and incision length（all P 〈 0.05）. The scores of VAS in the observation group right after the surgery, 6, 12 and 24 h after surgery were statistically lower than those in the control group（all P 〈 0.05）. The incidence of complications was6.7% in the observation group, but 22.2% in the control group（P 〈 0.05）. During the six-month follow-up, there was no case of recurrence; however, the excellent rate of cosmetic result and satisfaction degree of the patients were sig-nificantly higher in the observation group than in the control group（P 〈 0.05）. 【Conclusion】Minimally invasive biopsy system for excision is an effective, safe and cosmetic operation in the treatment of benign breast mass, which could effectively excise mass with low recurrence rate. Meanwhile, it could significantly decrease bleeding volume,shorten operation time, healing time of incision and incision length, alleviate postoperative pain and reduce incidence of complications, and is the first choice for patients meeting the criteria of this operative method.