乳管镜引导下手术切除治疗自发性溢液乳腺疾病效果分析

Analysis efficacy of ductoscopy in surgery excision for spontaneous nipple discharge

目的:评估乳管镜引导下手术切除治疗自发性溢液乳腺疾病(SND)的疗效。方法:SND患者223例,其中乳镜管引导下手术117例为实验组,常规治疗106例为对照组,比较两组疗效,分析临床诊断结果与病理特征的相关性。结果:实验组和对照组患者的年龄,溢液特征以及病灶区域不存在统计学差异,但两组患者手术时间(P=0.002),手术切除标本质量(P=0.028)以及出血量(P=0.035)存在统计学差异,临床诊断结果与病理特征分析相关性较高(P<0.001)。乳腺非增殖性病变为22例,乳头状瘤的发生率为59.1%(OR=21.4,95%CI=0.3~2.6,P=0.015)。乳腺增生患12例,乳头状瘤的发生率为83.3%(OR=6.8,95%CI=4.1~8.8,P=0.002)。乳腺癌患者为8例,乳头状瘤7例,发生率为87.5%(OR=7.4,95%CI=6.2~9.1,P=0.001)。住院时间实验组长于对照组(P<0.001)。对患者术后一年的满意度实验组高于对照组(P=0.001)。结论:乳管镜引导下手术治疗能够明确病灶部位,具有操作简单精确,使用方便,创伤小等优势,可应用于自发性溢液乳腺疾病的治疗。

Objective:To analysis the efficacy of ductoscopy in surgery excision for spontaneous nipple discharge(SND)patients.Methods:233 SND patients were selected.The patients were divided into two groups according to the operation method.Ductoscopy guided surgery excision patients was experimental group,and traditional treatment was the control group.The difference of two groups of patients with clinical diagnosis and pathological characteristics were used t,Fisher andχ^2 text to analysis.The single factor Logistic regression was used to compute the OR value.Results:There is no statistical difference in age,SND characteristics and lesion area between the experimental group and control group.The operation time(P=3.187)of experiment group were higher than control group,which were statistical differences.The surgical removal of the specimen weight(P=2.218)and the bleeding(P=2.136)of experiment group were lower than control group,which were statistical differences.The number of nonproliferative were 22 cases.The incidence of papilloma in nonproliferative was 59.1%,and the OR value was 21.4(95%CI,0.3~2.6,P=0.015).The number of Hyperplasia were 12 cases.The incidence of nonproliferative in hyperplasia was 83.3%,and the OR value was 6.8(95%CI,4.1~8.8,P=0.002).The number of cancer were 12 cases.The incidence of nonproliferative in cancer was 87.5%,and the OR value was 7.4(95%CI,6.2~9.1,P=0.001).The experimental group(P<0.001)had taken Longer time stay in hospital.Satisfaction survey found that the patient's satisfaction of experimental group is higher than the control group(P=17.031)after one year,which was statistical differences.Conclusion:Ductoscopy guided Surgery Excision which was clear lesion,simple,accurate,easy to use,and small trauma,can be used in the treatment of spontaneous nipple discharge.