良性乳腺肿块采用两种术式的临床效果分析

Comparison of clinical efficacy and safety of two surgical methods in the treatment of benign breast mass

目的探讨微创旋切术与传统开放手术治疗良性乳腺肿块的临床效果与安全性。方法选取2013年2月至2016年2月收治的294例良性乳腺肿块患者,按照随机数字表法分为微创手术组、开放手术组,各147例,分别实施微创旋切术与传统开放手术治疗。所有数据采用SPSS18.0进行分析,美观度评价、术后并发症发生率以[例(%)]表示,采用χ2检验;手术情况、疼痛程度等计量资料以(x珋±s)表示,采用t检验,以P<0.05为差异有统计学意义。结果微创手术组手术时间、术中出血量、切口长度及切口愈合时间均低于开放手术组,但住院费用高于开放手术组;微创手术组术后并发症发生率为4.8%,低于开放手术组的19.7%,差异均有统计学意义(P<0.05)。两组患者术后6 h VAS评分均较术后即刻升高,而后逐渐下降,微创手术组各时期VAS评分均低于开放手术组;两组患者随访期间均未见良性乳腺肿块复发,微创手术组末次随访时切口美观度优良率为94.4%,高于开放手术组的78.5%,差异均有统计学意义(P<0.05)。结论较传统开放手术而言,微创旋切术能够在取得相同治疗效果的前提下,进一步减少手术创伤、缩短术后恢复时间、降低术后并发症发生风险,可作为良性乳腺肿块的首选治疗术式。

Objective To investigate the clinical efficacy and safety of minimally invasive excision and traditional open surgery in the treatment of benign breast mass. Methods 294 cases benign breast mass patients were collected from February 2013 to February 2016 in our hospital and randomly divided into two groups,including 147 cases who received minimally invasive excision as minimally invasive group,while147 cases who received traditional open surgery as open surgery group. Statistical analysis were performed by using SPSS 18. 0 software,the appearance of the evaluation,the incidence of postoperative complications were presented as % and examined by chi square test,operation condition,the degree of pain were presented as and examined by using t test,A P value of 0. 05 was considered as significant difference.Results The operative time,blood loss,length of incision and wound healing time of the minimally invasive group were significantly lower than those in the open surgery group,but the cost of hospitalization was significantly higher than that of open surgery group; the incidence of complications in the minimally invasive group was 4. 8%,which was significantly lower than that in the open surgery group of 19. 7%,the difference were statistically significant（P〈0. 05）. Compared with the level before the operation,the VAS scores after the operation for 6 hour in both of the two groups increased immediately,and decreased gradually,the VAS scores of each time in the minimally invasive group were all lower than those in the open surgery group,the difference were statistically significant（P〈0. 05）. There was no recurrence of benign breast mass of the two groups during the follow-up time,the excellent rate of cosmetic at the end of follow-up time in the minimally invasive group was 94. 4%,which was higher than that in the open surgery group of 78. 5%,the difference was statistically significant（P〈0. 05）. Conclusion Compared with traditional open surgery,the minimally invasion excision can achieve the same therapeutic effect in the premise,to further reduce surgical trauma,shorten the postoperative recovery time,reduce the risk of postoperative complications,which can be used as the first choice for the treatment of benign breast lumps.