追踪<1cm乳腺增生结节患者不同治疗方法的效果

Racking the effects of different treatment methods on patients with less than 1cm breast hyperplasia

目的通过对彩超普查发现<1cm乳腺增生结节患者进行不同方法治疗,并随访3年,观察其影像学监测的结果,探讨对彩超普查发现<1cm乳腺增生结节患者不同治疗方法的价值。方法经彩超普查发现的<1cm乳腺增生结节患者507例,根据自愿原则进行非手术治疗304例、手术切除104例、麦默通(Mammotome,即真空辅助旋切)切除53例、超声聚焦刀治疗29例、氩氦刀治疗17例,随访3年,观察结节的影像学变化,评估对彩超普查发现的<1cm乳腺增生结节患者各种治疗方法的价值。结果结节直径变化、影像学评分与疼痛评分,各组治疗后3年与治疗前差异均有统计学意义(P<0.05)。治疗后3年手术治疗、麦默通治疗、超声聚焦刀治疗、氩氦刀治疗结节直径、影像学评分、疼痛评分均较非手术治疗减小或降低(P<0.05)。治疗后疼痛评分手术治疗、麦默通治疗、超声聚焦刀治疗均高于氩氦刀治疗(P<0.05)。手术治疗、麦默通治疗、超声聚焦刀和氩氦刀治疗均有复发结节(P<0.05),但各组间差异均无统计学意义(P>0.05)。结论随着时间的延长,<1cm乳腺增生结节保守治疗有风险,手术治疗和麦默通治疗优于超声聚焦刀治疗和氩氦刀治疗。

Objective To treat the patients by different methods and to follow up for 3 years, and to observe the image monitoring results and analysis of breast ultrasound census found 1 cm hyperplasia of breast nodules in patients with breast hyperplasia less than 1 cm found by breast color Doppler. Methods Five hundred and seven cases with〉1 cm hyperplasia of breast nodules were found by breast ultrasound screening. 304 cases were used conservative treatment according to the voluntary principle. 104 cases were used by surgical resection. 53 cases were used by Mammotome （Mamotome, namely vacuum assisted rotation cut）. 29 cases were used by high intensity focused ultrasound（HIFU）. 17 cases were used by argon helium knife treatment. After 3 years of follow-up, nodule image changes were observed to evaluate the value of breast ultrasound census found 〈1 cm hyperplasia of breast nodules with various treatments. Results The differences in nodule diameter variation, imaging score and pain score after 3 years of treatment in each group were statistically significant; compared to that before the treatment. There were statistical differences in nodule diameter, radiographic score, pain score. Mammotome treatment, ultrasonic focusing knife treatment, treatment of argon helium knife were lower in surgery group than that in non surgical treatment（P〈0. 05）. Treatment of pain score after surgery, Mammotome therapy, focused ultrasound in the treatment were higher than that of argon helium cryoablation （P〈0.05）. Surgery, Mammotome treatment, ultrasonic focusing knife and argon helium knife treatment have recrudesce tubercle. And the difference was significant in the third year of treatment（P〈0.05）. But there were no significant differences between the groups （P〉 0.05 ）. Conclusion With the extension of time. there is a risk for conservative treatment on 〈1cm hyperplasia of breast nodules. And surgical treatment and Mammotome treatment is superior to the ultrasonic focusing knife treatment and argon helium knife treatment.