超声引导穿刺在普通外科中的应用

目的　探讨高频超声在乳腺隐匿性病灶检出、超声引导穿刺定位切除活检和乳腺囊肿穿刺治疗的应用价值。同时介绍腹腔脓肿与积液的超声引导穿刺引流,超声引导PTCD。方法　1993年至今共检出乳腺隐匿性病灶250处,并在超声引导下作穿刺定位病灶切除术。对30处乳腺囊肿在超声引导下作穿刺治疗。5例腹腔脓肿、积液患者在超声引导下作穿刺引流。4例梗阻性黄疸患者在超声引导下行PTCD。结果　高频超声对乳腺隐匿性肿瘤诊断符合率为90%。同时检出9例隐匿性乳腺癌。5例腹腔脓肿、积液患者4例通过穿刺引流治愈。4例PTCD者3例引流成功。结论　超声为乳腺隐匿性病灶的检出、手术定位和囊肿穿刺治疗提供了有效手段。腹腔积液或脓肿超声下穿刺引流是一有效的非手术治疗,超声为PTCD提供了又一有效的引导方法。

The Appl ication of Ultrasound Guided Puncture in the Field of General Surgery

Objective To assess the value of high frequency ultrasound used in the inspection of breast nonpalpable lesion,the excision and biopsy of the lesion and the puncture of the breast cyst guided by ultrasound.To introduce the punctured drainage of the abdominal abscess or liquid accumulation,and the PTCD technique under the guiding of ultrasound.Methods Since 1993,under the guiding of ultrasound,250 breast nonpalpable lesions have been inspected and then removed successfully,30 breast cysts have been treated by puncture,5 abdominal abscess or liquid accumulation have been punctured and drained,4 cases of obstructed jaundice have been treated by PTCD. Results The diagnostic accuracy of the high frequency ultrasound on breast nonpalpable tumor is 90%.By this way,9 cases of breast cancer have been confirmed.4 in 5 cases of abdominal abscess or liquid accumulation have been cured by punctured drainage.3 in 4 cases under PTCD have been successfully drained. Conclusion Ultrasound may provide an effective method for the inspection of breast nonpalpable lesion,the location of operation and the puncture of cyst.The drainage of abdominal abscess or liquid accumulation under ultrasound may become an effective nonoperative treatment.And ultrasound maybe another effective leading route for PTCD.