两种乳腺X线定位活检设备在钙化灶中的应用效果

Application of two types of X-ray localization biopsy device for breast in diagnosing calcified lesions

目的比较坐位式与俯卧位式乳腺X线立体定位活检设备在钙化灶中的应用效果。方法选取2019年1月至2021年12月徐州市中心医院因乳腺钙化灶行X线引导下立体定位穿刺活检的患者242例,根据活检使用的设备,将患者分为坐位组120例,俯卧位组122例。比较两组病理诊断结果、准备时间、手术时间、术后并发症及患者疼痛评分、患者满意度评分等。结果坐位组准备时间为(3.60±1.29)min,操作时间为(30.35±11.16)min,俯卧位组准备时间为(3.22±1.14)min,操作时间为(25.91±6.61)min,差异均有统计学意义(均P<0.05)。坐位组疼痛评分为(1.61±0.84)分,俯卧位组为(1.49±0.73)分,差异无统计学意义(P=0.251)。坐位组术后1例出现伤口感染,俯卧位组无伤口感染患者。术后局部血肿坐位组10例,俯卧位组8例。坐位组4例患者出现血管迷走神经反应,俯卧位组无血管迷走神经反应发生。两组总并发症比较差异无统计学意义(P>0.05)。两组伤口感染、局部血肿的发生率差异无统计学意义(P>0.05),而血管迷走神经反应发生率差异有统计学意义(P<0.05)。俯卧位组患者满意度达97.5%,优于坐位组的91.7%,差异有统计学意义(P=0.043)。坐位组和俯卧位组恶性病变检出率分别为6.7%(8/120)、9.0%(11/122),差异无统计学意义(P=0.675)。结论使用俯卧式X线立体定位活检设备比坐位式可更快地完成活检,并且可以减少迷走神经反应的发生。

Objective To compare the application effect of sitting position versus prone position for X-ray-guided stereotactic breast biopsy in diagnosing calcified lesions.Methods A total of 242 patients with mammary calcified lesions,who received X-ray-guided stereotactic breast biopsy at the Xuzhou Central Hospital of China between January 2019 and December 2021,were enrolled in this study.According to the equipment used for biopsy,the patients were divided into stting position group(n=120)and prone position group(n=122).The pathological diagnosis,the time spent for preparation,the time spent for operation,postoperative complications,patient's pain score,and patient's satisfaction score were compared between the two groups.Results In the stting position group and prone position group,the mean time spent for preparation was(3.60+1.29)min and(3.22±1.14)min respectively,and the mean time spent for operation was(30.35±11.16)min and(25.91±6.61)min respectively,the differences between the two groups were statistically significant(both P<0.05);the pain score was(1.61±0.84)points and(1.49±0.73)points respectively,the difference between the two groups was not statistically significant(P-0.251).After the puncture biopsy,one patient in the sitting position group developed wound infection,while in the prone position group no wound infection occurred.Postoperative local hematoma occurred in 10 patients of the sitting position group and in 8 patients of the prone position group.Four patients in the siting position group experienced vasovagal reaction,while no patient in the prone position group developed vasovagal reaction.The difference in the total complications between the two groups was not statistically significant(P>0.05).No statistically significant differences in the incidences of wound infection and local hematoma existed between the two groups(P>0.05),while the difference in the incidence of vasovagal reaction between the two groups was statistically significant(P<0.05).The patient's satisfaction rate in the prone position group was up to 97.5%,which was higher than 91.7%in the siting position group,the dfference between the two groups was statistically significant(P-0.043).Pain scoring results indicated that the pain degree of biopsy in the sitting position was similar to that in the prone position(P=0.251).The detection rate of malignant lesions in the sitting position group and the prone position group was 6.7%(8/120)and 9.0%(11/122)respectively,the difference between the two groups was not statistically significant(P-0.675).Conclusion The biopsy operation by using prone X-ray stereoscopic positioning biopsy equipment can be accomplished faster than by using seated X-ray stereoscopic positioning biopsy equipment,besides,prone position can reduce the occurrence of vasovagal reaction.