廖樺　方志紅　陳龍林

【摘要】 目的：探討微創(chuàng)旋切技術(shù)治療多發(fā)乳腺小結(jié)節(jié)的應用效果。方法：選取2015年7月-2018年6月本院收治多發(fā)乳腺小結(jié)節(jié)患者250例，按不同外科手術(shù)方式分為微創(chuàng)手術(shù)（minimally invasive surgery，MIS）組和開放手術(shù)（conventional open excision，COE）組，每組125例。MIS組給予微創(chuàng)旋切技術(shù)治療，COE組給予開放手術(shù)治療。比較兩組手術(shù)時間、術(shù)中出血量、拔管時間、切口愈合時間、乳房美容效果、術(shù)后6個月復發(fā)率及并發(fā)癥發(fā)生率。結(jié)果：MIS組手術(shù)時間、術(shù)中出血量、拔管時間、切口愈合時間及術(shù)后6個月并發(fā)癥發(fā)生率均明顯低于COE組（P<0.05）。MIS組乳房美容效果優(yōu)良率明顯高于COE組（P<0.05）。兩組術(shù)后6個月復發(fā)率比較，差異無統(tǒng)計學意義（字2=0.044，P>0.05）。結(jié)論：與開放手術(shù)相比，微創(chuàng)旋切技術(shù)治療多發(fā)乳腺小結(jié)節(jié)具有明顯優(yōu)勢。

【關(guān)鍵詞】 微創(chuàng)旋切技術(shù); 乳腺小結(jié)節(jié); 多發(fā)性; 乳腺疾病

Clinical Study of Minimally Invasive Rotary Cutting Technique in the Treatment of Multiple Breast Small Nodules/LIAO Hua，F(xiàn)ANG Zhihong，CHEN Longlin.//Medical Innovation of China，2019，16（18）：-114

【Abstract】 Objective：To explore the application effect of minimally invasive rotary cutting technique in the treatment of multiple breast small nodules.Method：250 patients with multiple breast small nodules admitted to our hospital from July 2015 to June 2018 were selected.They were divided into minimally invasive surgery（MIS）group and open surgery（COE）group according to different surgical methods，125 cases in each group.The MIS group was treated with minimally invasive rotary cutting technique，while the COE group was treated with open surgery.The operation time，intraoperative blood loss，extubation time，incision healing time，breast cosmetic effect，recurrence rate and complication rate 6 months after surgery of the two groups were compared.Result：The operation time，intraoperative blood loss，extubation time，incision healing time and the incidence of complications 6 months after surgery in the MIS group were significantly lower than those in the COE group（P<0.05）.The excellent rate of breast cosmetic effect in the MIS group was significantly higher than that in the COE group（P<0.05）.There was no significant difference in recurrence rate 6 months after surgery between the two groups（P>0.05）.Conclusion：Compared with open surgery，minimally invasive rotary cutting technique has obvious advantages in the treatment of multiple small breast nodules.

【Key words】 Minimally invasive rotary cutting technique; Breast small nodules; Multiple; Breast diseases

First-authors address：Dafeng Hospital of Chaoyang District，Shantou 515154，China

doi：10.3969/j.issn.1674-4985.2019.18.029

開放手術(shù)治療多發(fā)乳腺小結(jié)節(jié)的手術(shù)入路主要有環(huán)乳暈切口、雙環(huán)乳暈切口、弧形切口及放射狀切口，此類手術(shù)入路的切口長度長及愈合后瘢痕明顯，破壞了乳房表面皮膚的完整和外觀[1-4]。同時，開放手術(shù)治療多發(fā)乳腺小結(jié)節(jié)要通過上述手術(shù)入路構(gòu)建皮下隧道來剔除病灶，在構(gòu)建皮下隧道時不可避免對乳房的結(jié)構(gòu)造成明顯損傷，以至于手術(shù)后造成乳房毀形[5-6]。

隨著人文環(huán)境的改變，女性對乳房保健和乳房美學的重視程度加深，人們對普外科治療多發(fā)乳腺小結(jié)節(jié)的微創(chuàng)醫(yī)學和美學效果提出了更高要求[7-10]。開放手術(shù)已經(jīng)無法滿足人們對微創(chuàng)醫(yī)學和美學效果方面提出的新要求[11-14]。近期，本院采用微創(chuàng)旋切技術(shù)治療多發(fā)乳腺小結(jié)節(jié)獲得良好療效，本著為微創(chuàng)旋切技術(shù)治療多發(fā)乳腺小結(jié)節(jié)提供參考和依據(jù)的目的，將本研究患者的臨床資料分析、總結(jié)。現(xiàn)報道如下。