水分离技术在乳腺良性病变微创旋切中临床应用分析

Clinical application analysis of hydrodissection technique in minimally invasive rotation of benign breast masses

目的探讨水分离技术在乳腺良性病变微创旋切中的临床应用效果。方法选择行乳腺良性病变微创旋切术的女性患者140例,年龄20~60岁,平均年龄36.73岁;病程3~14个月,平均病程7.36个月;病灶直径6~28 mm,平均病灶直径14.19 mm;其中左侧78例,右侧62例。按手术方式不同,随机分为两组,即对照组(传统微创组70例)和观察组(水分离微创组70例)。观察两组患者在手术时间、术中视觉模拟量表(VAS)评分、术中出血量、病变切除完整程度及术后近期并发症(1周内)进行比较。结果经病理组织检查证实均为良性病变,其中纤维腺瘤105例,乳腺腺病15例,纤维囊性乳腺病16例,良性乳头状瘤2例,炎性病变2例。两组在病变切除完整程度上均为完整切除,差异无统计学意义(P>0.05);观察组术中VAS评分、术中出血量、手术时间均小于对照组[(2.68±1.06)分vs(4.66±1.36)分、(4.08±0.83)mL vs(9.93±0.68)mL、(16.32±4.11)分vs(30.45±6.23)分],且差异有统计学意义(P<0.05);观察组术后切口渗血渗液、皮肤淤斑、皮下血肿发生率均少于对照组(1.43%vs 7.14%、4.29%vs 8.57%、2.86%vs 7.14%);两组术后近期并发症(1周内)总发生率比较,观察组少于对照组(8.57%vs 22.86%),差异均有统计学意义(P<0.05)。结论在乳腺良性病变微创旋切术中应用水分离技术后,可以降低疼痛程度、减少出血量、缩短手术时间,术后并发症较少,有助于术后恢复。

Objective To analyze the clinical effect of hydrodissection technique in minimally invasive rotation of benign breast lesions.Method A total of 140 female patients with benign breast lesions performed minimally invasive rotation were enrolled,which aged 20-60 years old with mean age of 36.73 years old.The disease course was 3-14 months with mean course of 7.36-month;lesion diameter was 6-28 mm with mean diameter of 14.19 mm.Seventy-eight cases were on the left side and 62 cases were on the right side.According to different operation methods,all of them were randomly divided into control group(n=70,traditional minimally invasive rotation group)and observation group(n=70,hydrodissection minimally invasive rotation group).The operation time,intraoperative visual analog scale(VAS)score,intraoperative blood loss,completeness of resection and postoperative complications(within 1-week)between 2 groups were compared.Results All of them were benign lesions confirmed by pathological examination,which included 105 cases of fibroadenoma,15 of breast adenopathy,16 of fibrocystic breast disease,2 of benign papilloma and 2 of inflammatory lesions.All lesions were complete resection,and there was no significant difference between 2 groups in completeness of resection(P>0.05).The intraoperative VAS score,intraoperative blood loss and operation time in observation group were statistically significantly less than those in control group[(2.68±1.06)scores vs(4.66±1.36)scores,(4.08±0.83)mL vs(9.93±0.68)mL,(16.32±4.11)scores vs(30.45±6.23)scores](P<0.05).The incidences of postoperative incision blood exudation,skin ecchymosis and subcutaneous hematoma in observation group were lower than those in control group(1.43%vs 7.14%,4.29%vs 8.57%,2.86%vs 7.14%).The total incidence of postoperative complications(within 1 week)in observation group was statistically significantly less than that in control group(8.57%vs 22.86%.P<0.05).Conclusion It is demonstrated that hydrodissection technique in minimally invasive rotation of benign breast lesions could reduce pain level,blood loss and operation time and have less postoperative complications,which is helpful for postoperative recovery.