超声引导下真空辅助微创旋切系统治疗与开放性手术治疗导管内乳头状瘤的疗效观察

Effect of Ultrasound-guided Vacuum-assisted Minimally Invasive Atherectomy System and Open Surgery in the Treatment of Intraductal Papilloma

目的:探讨超声引导下真空辅助微创旋切系统治疗与开放性手术治疗导管内乳头状瘤的疗效。方法:回顾性分析某院2018年1月~2020年6月收治的169例导管内乳头状瘤(intraductal papilloma,IP)患者,按手术方式不同分为行超声引导下真空辅助微创旋切术(微创组)116例和行传统开放性手术(传统组)53例。比较两组手术时间、术中出血量、切口长度、愈合时间、术后伤口内积液量、积液时间在内的围术期情况,比较术后疼痛、瘀斑、血肿、切口感染及复发等并发症发生率,比较术后满意度情况(其中总满意度等于满意与一般之和)。结果:微创组手术时间、术中出血量、切口长度、愈合时间、术后伤口内积液量及积液时间均小于传统组,且两组差异具有显著性(P<0.05);两组除瘀斑情况无明显差异(P>0.05)外,相较于传统组而言,微创组疼痛、血肿、切口感染及复发人数均明显较少,且比较具有统计学差异(P<0.05);经秩和检验可知两组满意度差异显著(Z=-11.560,P=0.000),且微创组总满意度100%(116例)明显高于传统组86.79%(46例),差异具有统计学意义(P<0.05)。结论:超声引导下真空辅助微创旋切系统定位准确、精准切除、瘢痕较小,能够提升IP患者的治疗效果,减少术后并发症发生率,提高预后效果,更易被女性患者接受,在微创理念已经得到广泛确立的大背景下,该方案值得临床推广。

Objective:To investigate the efficacy of ultrasound-guided vacuum-assisted minimally invasive atherectomy system and open surgery for intraductal papilloma.Methods:169 patients with intraductal papilloma(IP)admitted to a hospital from January 2018 to June 2020 were retrospectively analyzed.According to different surgical methods,they were divided into vacuum-assisted minimally invasive atherectomy under ultrasound guidance group(minimally invasive group,116 cases)and traditional open surgery group(traditional group,53 cases).The perioperative conditions including operation time,intraoperative blood loss,incision length,healing time,postoperative fluid accumulation in the wound,and fluid accumulation time,the incidence of complications such as postoperative pain,ecchymosis,hematoma,incision infection,and recurrence,and the postoperative satisfaction(the total satisfaction was equal to the sum of satisfaction and general)were compared between the two groups.Results:The operation time,intraoperative blood loss,incision length,healing time,postoperative fluid accumulation in the wound and fluid accumulation time in the minimally invasive group were less than those in the traditional group,and the difference between the two groups was significant(P<0.05).Except that there was no significant difference in ecchymosis(P>0.05),compared with the traditional group,the number of pain,hematoma,incision infection and recurrence in the minimally invasive group was significantly less,and the difference was statistically significant(P<0.05).The rank sum test showed that there was a significant difference in satisfaction between the two groups(Z=-11.560,P=0.000),the total satisfaction degree of the minimally invasive group(100%,116 people)was significantly higher than the traditional group(86.79%,46 people),and the difference was statistically significant(P<0.05).Conclusion:The ultrasound-guided vacuum-assisted minimally invasive atherectomy system has accurate positioning,precise resection,and small scars,which can improve the treatment effect of IP patients,reduce the incidence of postoperative complications,improve the prognosis,and be more acceptable to female patients.Under the background that the minimally invasive concept has been widely established,the program is worthy of clinical promotion.