乳腺纤维导管镜在乳头溢液疾病中的诊治价值

Value of fiberoptic ductoscopy in the diagnosis and treatment of breast disease with nipple discharge

目的探讨乳腺纤维导管镜在乳头溢液疾病中的诊治价值。方法应用乳腺纤维导管镜对100例乳头溢液患者进行诊断,直接观察乳腺导管内的情况,初步判断其疾病性质并准确定位。并将检查结果与术后病理诊断进行对比分析。结果 100例患者中乳管炎35例,乳管扩张症26例,乳管内占位性病变39例(乳管内乳头状瘤32例,乳管内乳头状瘤病4例,乳腺导管浸润癌3例)。病理检查结果与镜下诊断符合率为87.18%(34/39)。乳管炎和乳管扩张症患者于检查后直接进行镜下药物灌注治疗,治愈或好转率为89.09%。乳管内占位性病变患者均行手术治疗。结论纤维乳腺导管镜检查可以明确乳头溢液病因,直接、安全、有效。且在其协助下经溢液乳孔放置乳腺定位针进行手术,可避免手术盲目性。

Objective To assess the value of fiberoptic ductoscopy in the diagnosis and treatment of breast disease with nipple discharge. Methods Fiberoptic ductoscopy was performed on 100 patients with nipple discharge to observe mam-mary duct directly, to initially evaluate breast disease peculiarity and to locate them definitely. And then the examination results were compared with the postoperative pathologic diagnosis. Results Out of the 100 patients, 39 were found with intraduetal space -occupying lesion （SOL） （32 cases with intracanalicular papilloma, 4 cases with intraeanalicu- lar papillomatosis, 3 case with invasive duetal carcinoma）, 35 with mastadenitis and 26 with mammary dueteetasia （MDE）. The pathologic results of papillary epithelioma were coincident with endoscope diagnoses at a rate of 87.18% （34/39）. 89.09% of patients cured or improved was found in the SOL patients given surgical treatment and in the MDE patients given mirror in therapy of drugs. Conclusion Fiberoptic ductoscopy is a safe, effective and accurate method in the initial diagnosis of nipple discharge. Surgery blindness can be avoided by using fiberoptic ductoscopy.