乳腺真空辅助活检术后留置导尿管球囊压迫止血的临床研究

Hemostasis with balloon urinary catheter after vacuum.assisted breast biopsy

目的探讨乳腺真空辅助活检（vacuum-assisted breast biopsy, VABB）术后留置导尿管球囊压迫止血的临床效果。方法收集广东省妇幼保健院2016年5月至2017年5月行VABB的患者共270例，按随机数字表法分为观察组和对照组，各135例。观察组接受VABB术后留置导尿管球囊压迫止血，对照组接受VABB术后常规行胸带加压包扎止血。比较2组术后出血和术后血肿发生的情况。结果观察组术后出血和术后血肿发生率（6．7％VS8．9％）显著低于对照组（16．3％VS24．4％），差异有统计学意义（P〈0．05）。病灶≤1．5cm的患者中，观察组术后出血和术后血肿发生率（1．6％VS4．7％）低于对照组（6．5％VS8．1％），但差异无统计学意义（P〉0．05）；病灶〉1．5cm的患者中。观察组术后出血和术后血肿发生率（11．3％VS12．7％）低于对照组（24．7％VS32．9％），差异有统计学意义（P〈0．05）。结论VABB术后留置导尿管球囊压迫止血可有效降低术后出血和血肿。值得在临床中推广应用。

Objective To evaluate the hemostasis effect of balloon urinary catheter after vacuum-assist- ed breast biopsy （VABB）. Methods From May. 2016 to May. 2017, 270 patients undergoing VABB were random- ized into study group （135 cases） and control group （135cases）. Patients in the study group received VABB postop- erative indwelling catheter balloon hemostasis, while patients in the control group received VABB postoperative con- ventional thoracic pressure bandage to stop bleeding.Postoperative bleeding and hematoma were recorded and com- pared between the two groups. Results The rates of postoperative bleeding and hematoma in the study group were significantly lower than that in the control group （6.7% vs 16.3%, P〈0.05; 8.9% vs 24.4%, P〈0.05）. Among patients with lesions ≤ 1.5 cm, the rates of postoperative bleeding and hematoma were 1.6% and 4.7% in the study group, and 6.5% and 8.1% in the control group. There was no significant difference between the two group （P〉0.05）. Among patients with lesions 〉1.5 cm, the rates of postoperative bleeding and bematoma in the study group were significantly lower than those in the control group （11.3% vs 24.7%, P〈0.05; 12.7% vs 32.9%, P〈0.05）. Conclusion Hemostasis with balloon urinary catheter is a safe and effective method for postoperative bleeding and hematoma control after VABB.