钼靶引导下导丝定位手术切检不可触及乳腺病灶的临床分析

Clinical application of hook wire-localized surgical biopsy guided by mammography for non-palpable breast lesions

目的:评价钼靶引导下钩丝定位引导手术切检临床不可触及乳腺病灶的有效性及安全性。方法:回顾性分析78例临床触诊阴性而乳腺钼靶X线显示的小病灶,其中35例采用大体定位法进行定位(A组),43例采用乳腺钼靶X线引导导丝定位(B组),指导临床进行手术切检。结果:B组一次性完整切除病灶成功率为93.02%(40/43),高于A组的74.29%(26/35)(P<0.05)。B组导丝的定位满意率为90.70%。穿刺定位平均时间14.8 min。所有病人均未出现导丝折断、气胸、大出血等并发症,4例病人定位过程中发生迷走神经反应,经休息数分钟后缓解,顺利完成手术。结论:钼靶X线引导穿刺钩针定位准确性较高,是诊治临床不可触及乳腺病变安全、有效的方法。

Objective： To assess the efficacy and safety of hook wire-localized surgical biopsy guided by mammography for non-palpable breast lesions.Methods： The clinical data of 78 female patients with micro-lesions diagnosed by mammography,negative mammary diagnosed by palpation,were retrospectively analyzed.Thirty-five cases were treated with surgical biopsy located by general position method（group A）,and 43 cases were treated with surgical biopsy located by hook wire guided by mammography（group B）.Results： The disposable complete resection rate in group B（93.02%） was higher than that in group A（74.29%）（ P 〈0.05）.The satisfaction rate and mean time of puncturing localization in group B was 90.70% and 14.8 minutes,respectively.No guidance wire break,pneumothorax and massive hemorrhage in group B were found.The vagal response occurred in 4 cases,the symptom relieved after rest,and the operation of patients were successfully completed.Conclusions： The hook wire-localized surgical biopsy guided by mammography has a high accuracy,which is safe and effective in diagnosing non-palpable breast lesions.