乳管内窥镜对乳腺导管内病变的诊断和治疗价值
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The value of breast fiberoptic ductoscopy in diagnosis and treatment of intraductal breast lesions
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    摘要:

    目的:评价乳管内窥镜(FDS)对乳腺导管内疾病的诊断和治疗价值。
    方法:回顾性分析近2年来FDS检查的548例乳头溢液患者的临床资料。
    结果:548例乳头溢液病例中,FDS下诊断为乳管炎59例(10.8%),乳腺导管扩张症117例(21.4%),乳腺导管扩张合并乳管炎185例(33.4%),乳管内乳头状瘤159例(29.0%),乳管内乳头状瘤病12例(2.2%),乳腺癌16例(2.9%)。135例在我院接受手术治疗,其中91例在FDS定位下行肿瘤切除或区段切除手术(甲组),44例按常规经溢液乳管内注射染料美蓝后再行选择性区段切除(乙组)。甲组术后FDS诊断符合率97.8%(89/91)明显高于乙组的86.4%(38/44)(χ2=6.96,P=0.008)。
    结论:FDS不仅是诊断乳腺导管内病变的可靠方法,而且可以帮助手术中定位切除乳腺导管内新生物。FDS定位下手术能够避免盲目性,为病灶的切除提供可靠的帮助。

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    Abstract:Objective:To evaluate the value of breast fiberoptic ductoscopy(FDS)in diagnosis and treatment of intraductal lesions.
    Methods :The clinical data of 548 patients with nipple discharge who underwent FDS from Sep 2004 to Nov 2006 were retrospectively analyzed.
    Results:Of 548 patients with nipple discharge, the FDS diagnosis was galactophoritis in 59 cases, ductal ectasia in 117 cases, ductal ectasia coexistent with galactophoritis in 185 cases, intraductal papilloma in 159 cases, intraductal papillomatosis in 12 cases and breast carcinoma in 16 cases.One hundred and thirty-five cases had surgical therapy in our hospital,among them,91 cases had tumor resection or segmentectomy under localization by FDS, and 44 cases had segmentectomy after breast duct infusion with methylene blue. The diagnostic conformity rate of FDS localization group(97.8%)was significantly higher than that of breast duct infusion of methylene blue group(86.4%)(P<0.01).
    Conclusions:FDS is not only a reliable method of diagnosis for patients with breast intraductal lesion, but can assist in localization and in operative removal of breast intraductal neoplasm. The localization by FDS can avoid blindness of operation and help to improve the detection of intraductal lesions.

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吴唯, 李小荣, 杨开焰, 丁波泥, 陈道瑾.乳管内窥镜对乳腺导管内病变的诊断和治疗价值[J].中国普通外科杂志,2007,16(11):12-107.
DOI:10.7659/j. issn.1005-6947.2007.11.012

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  • 在线发布日期: 2007-11-25