纤维乳管镜对乳管内病变的诊疗价值

Value of fiberoptic ductoscopy in the diagnosis and treatment of intraductal lesions

目的观察纤维乳管镜对于乳管内病变的临床疗效。方法选取2016年8月至2017年12月首都医科大学附属北京中医医院乳腺科非生理性乳头溢液患者共计254例进行回顾性分析。结果对于乳管内非占位性病变,乳管镜冲洗有显著疗效。对于乳管内占位性病变,不同颜色、不同性状的乳头溢液,乳管镜诊断具有显著的意义,其中暗红色血性溢液、淡黄色浆液性溢液明显高于白色乳汁样、无色透明样;在对乳腺癌的诊断上暗红色血性组发病率最高。手术方式上:与传统手术比较,乳管镜定位下手术病理诊断符合率更高,差异有统计学意义(χ2=8. 194,P=0. 004)。结论乳管镜不仅能够诊断产生乳头溢液的病因,而且对于乳管内非占位性病变的乳头溢液,通过冲洗可起到良好的效果,对于乳管内占位性病变,乳管镜定位下手术可避免手术盲切,为准确切除病灶提高依据。

Objective To observe the clinical effects of fiberoptic ductoscopy on intraductal lesions. Methods The retrospective analysis was conducted on 254 patients of non-physiological nipple discharge treated in the Department of Breast Surgery,Beijing Chinese Medicine Hospital Affiliated to Capital Medical University. Results The rinsing with fiberoptic ductoscopy achieved the significant effects on intraductal non-space-occupying lesion. For the patients with intraductal space-occupying lesion with nipple discharge of different colors and properties,fiberoptic ductoscopy was significant in diagnosis. The number of cases with dark bloody discharge and pale yellow serous discharge was obviously higher than that of white milky or colorless discharge. Regarding the diagnosis of breast cancer,the incidence in the group with dark bloody discharge was the highest. In Surgery,compared with the traditional operation,under fiberoptic ductoscopy,the coincidence rate of pathological diagnosis was higher,indicating the significant difference(χ2= 8. 194,P = 0. 004). Conclusion Fiberoptic ductoscopy is advantageous not only at the diagnosis of the factors of nipple discharge,but also on the satisfactory effects on nipple discharge in intraductual non-space-occupying lesions by rinsing. For the space-occupying lesions,the operation under fiberoptic ductoscopy achieves the precise incision of lesions,avoiding the mistakes.