微创旋切术治疗乳腺导管扩张症的临床效果

Clinical effect of minimally invasive surgery in the treatment of mammary duct ectasia

目的探讨微创旋切术治疗乳腺导管扩张症的临床效果。方法回顾性分析2018年1月至2021年6月青岛市黄岛区人民医院收治的60例脓肿期乳腺导管扩张症患者,根据不同治疗方法分为对照1组、对照2组与观察组,每组各20例。对照1组采用常规开放手术,对照2组采用经皮穿刺抽液术,观察组采用微创旋切术。比较三组手术相关指标、乳导管直径、视觉模拟评分法(VAS)评分、并发症总发生率及复发率。结果观察组手术时间、切口长度、切口愈合时间均短于对照1组,且术中出血量少于对照1组(P<0.05)。观察组手术时间、切口长度、切口愈合时间长于对照2组,且术中出血量多于对照2组(P<0.05)。干预2周后,观察组乳导管直径短于对照1组和对照2组,VAS评分低于其他两组(P<0.05)。观察组复发率低于对照1组及对照2组(P<0.05)。三组并发症总发生率比较,差异无统计学意义(P>0.05)。结论将微创旋切术应用于脓肿期乳腺导管扩张症患者的治疗中,乳导管直径、VAS评分及复发率优于常规开放手术及经皮穿刺抽液术,手术相关指标优于常规开放手术。

Objective To investigate the clinical effect of minimally invasive surgery in the treatment of mammary duct ectasia.Methods Sixty patients with mammary duct ectasia in the stage of abscess treated in Huangdao District People’s Hospital of Qingdao City from January 2018 to June 2021 were retrospectively analyzed,and divided into control group 1,control group 2 and observation group according to different treatment methods,with 20 cases in each group.Conventional open surgery was performed in control group 1,percutaneous aspiration was performed in control group 2,and minimally invasive surgery was performed in observation group.The surgery-related indexes,mammary duct diameter,visual analogue scale(VAS)score,total complication rate and recurrence rate of the three groups were compared.Results The operation time,incision length and incision healing time of observation group were shorter than those of control group 1,and the amount of intraoperative blood loss was less than that of control group 1(P<0.05).The operation time,incision length and incision healing time in observation group were longer than those in control group 2,and the amount of intraoperative blood loss was more than that in control group 2(P<0.05).After 2 weeks of intervention,the mammary duct diameter in observation group was shorter than that in control group 1 and control group 2,and the VAS score was lower than that in the other two groups(P<0.05).The recurrence rate of observation group was lower than that of control group 1 and control group 2(P<0.05).There was no significant difference in the total incidence of complications among the three groups(P>0.05).Conclusion The application of minimally invasive surgery in the treatment of patients with mammary duct ectasia in the stage of abscess,the diameter of mammary duct,VAS score and recurrence rate are better than those of conventional open surgery and percutaneous aspiration,and the surgery-related indexes are better than those of conventional open surgery.