环乳晕切口联合术中B超定位在乳腺多发性纤维腺瘤手术中的应用152例分析

目的 探讨乳腺多发性纤维腺瘤的手术方式,为手术治疗乳腺多发性纤维腺瘤提供参考依据.方法 对2008年1月-2012年10月复旦大学附属妇产科医院乳腺外科诊治的152例乳腺多发性纤维腺瘤的临床资料进行回顾性分析,均应用术中B超定位、取环乳晕切口、经乳腺皮下脂肪层手术入路,切除乳腺多发性纤维腺瘤.分析手术切口设计、手术步骤及手术效果.结果 152例乳腺多发性纤维腺瘤在B超定位下切除.术后1个月和3个月随访时,评价结果医患双方有分歧（相关系数分别为0.894,P=0.106;0.905,P=0.065）,相关性差异无统计学意义.术后12个月随访时,不论患者还是医学观测者（相关系数为0.946,P＜0.001）,对胸部外形及瘢痕外观均表示满意（P＜0.05）.结论 B超定位下环乳晕切口乳腺皮下脂肪层入路能一次彻底切除乳腺多发性纤维腺瘤,美容效果好,缩短了手术时间,远期疗效肯定,有较好的临床应用价值.

Areola incision combined with intraoperative B-ultrasound guided treatment in multiple breast fibroadenoma surgery for 152 cases

Objective To explore the surgery methods for multiple fibroadenoma of breast, provide a ref- erence for the surgical treatment of breast multiple fibroadenoma. Methods The clinical data of 152 cases of breast multiple fibroadenoma admitted from January 2008 to October 2012 in Department of Breast Surger- y, Obstetrics and Gynecology Hospital of Fudan University were analyzed retrospectively. All the cases were applied intraoperative B-ultrasound guided, taken the areola incision through breast subcutaneous layer ap- proach for resection of multiple breast fibroadenoma. The surgical incision design, surgical procedures and results of operations were analyzed. Results All 152 cases fibroadenoma were resected which were guided by B-ultrasound with areola incision. One month and three months after operation, the assessment of physi- cian-patient for the scars were different. There was no significance in the Pearson Correlations which were 0. 894 （ P = 0. 106 ） and 0. 905 （ P = 0. 065 ）, respectively. But twelve months later, it satisfied with the ap- pearance of scar, either the patients or the doctors （ P 〈 0.05 ）. The Pearson Correlation was 0. 946 （P 〈 0. 001 ）. Conclusions B-ultrasound guided areola incision through the breast subcutaneous layer approach could removal multiple breast fibroadenoma at one time, patients were satisfacted with the good cosmetic re- sults, we believe this operation method has short operation time and good clinical value.