麦默通微创旋切治疗乳腺肿块效果观察

目的探讨麦默通微创旋切系统在乳腺肿块切除中的应用价值和前景。方法在超声引导下采用麦默通旋切系统对56例乳腺肿块患者行肿块切除术,观察临床效果。结果 56例共72个病灶均一次性完整切除,病理报告良性病灶69个,恶性病灶3个。术后出现局部皮肤青紫3例,乳房内血肿2例,均保守治疗治愈;3例乳腺浸润性导管癌患者给予手术、化疗等综合治疗。全部病例未发生感染及血气胸,随访半年未见复发。结论乳腺肿块采用超声引导下麦默通旋切系统切除,微创、美观、操作精简和并发症少的特点,安全性较高,值得临床推广。     

麦默通旋切术对乳腺良性肿瘤的治疗价值

目的探讨超声引导下麦默通微创旋切术对乳腺良性肿块的临床应用价值。方法对在津南区咸水沽医院行超声引导下麦默通微创旋切治疗的108例女性患者124处乳腺病灶进行总结,评价其疗效。结果所有病灶直径范围5~37mm,组织病理诊断乳腺纤维瘤105个,乳腺硬化性腺病11个,乳腺囊性增生8个。术后均未出现疼痛、出血、感染、皮肤损伤等并发症。结论超声实时引导下麦默通旋切系统为乳腺良性肿块的临床治疗提供了新的途径,不仅能够准确切除乳腺肿块,还具有微创、安全、有效、美容等优点,在减轻患者精神压力的同时还能提高生活质量,可以作为较小良性结节的首选治疗方法。     

超声引导下麦默通微创旋切术在体表良性肿块切除中的应用价值

目的 探讨麦默通微创旋切术在体表良性肿块切除中的临床应用价值.方法 超声引导下应用麦默通微创旋切系统对28例患者35枚体表良性肿块实施微创旋切术,评价其治疗效果.结果 超声动态显示麦默通微创旋切术的全过程,术中皮肤切口0.25～0.40cm,仅1例患者出现切口下小血肿;术后显示35枚肿块均一次完整切除,并获得明确病理诊断.随访3～12个月,均未见明显瘢痕,超声检查均未见肿块回声.结论 超声引导下麦默通微创旋切术治疗体表良性肿块具有定位准确、创伤小、出血少、易操作、并发症少及术后美观的优点,是对传统开放手术方式的良好补充和发展.     

麦默通旋切系统在乳腺微创术中的应用及配合体会

乳腺肿块是乳腺系统疾病中最常见的病变,应用麦默通微创旋切系统可完整切除3cm[1]以下的乳腺肿块。我院自2012年6月~2013年6月使用麦默通旋切系统对172例,直径3cm以下乳腺良性肿块进行切除,通过与对照组进行手术时间、术后并发症、术后复发率、手术费用及对伤口大小满意度的对比,发现超声引导麦默通微刨旋切系统在乳腺肿块切除术的应用中,具有微创、操作准确、安全、并发症少、美观等优点,特别对临床不能触及肿块的病例更有不可替代的作用[2],对一侧多个肿物的切除,更体现麦默通旋切系统的微创优势,很好地满足了女性形体美的需要[3],并通过术中及术后优质的护理措施能有效减少术后并发症。     

微创手术麦默通治疗150例乳腺良性肿块的临床研究

目的:观察微创手术—麦默通(Mammotome)在乳腺良性肿块切除中的疗效。方法:采用超声引导真空辅助乳房活检系统(麦默通)切除150例乳腺良性肿块,比较该方法与传统手术切除在术前准备、手术时间、术后并发症和恢复状况等方面的差别,评价其临床应用价值。结果:共切除162个良性肿块,皮肤切口平均为6 mm,旋切次数平均为10次,手术时间平均为15 min,术后超声扫描显示肿块完全被切除;术后并发症主要为轻度疼痛(68.0%)、局部血肿(5.3%)和乳房皮下淤血(2.7%),未见局部感染和气胸,患者未见明显瘢痕形成。结论:B超引导下的麦默通微创旋切系统在乳腺良性肿块切除中具有定位准确、切口小、出血少、患者恢复快的特点,是一种并发症少且安全可靠的治疗方法。     

麦默通微创旋切技术在乳腺病变诊治中的应用

目的 探讨麦默通微创旋切技术在乳腺病变诊断与治疗方面的临床应用价值.方法 在B超引导下对116例乳腺肿块或有可疑病变的患者进行麦默通微创旋切术,评价其诊断和治疗效果.结果 116例145处乳腺病灶经麦默通微创旋切术后获得明确病理诊断,良性病变同时获得治疗.术后发生切口下血肿5例(4.3%);皮下淤血斑21例(18.1%);无一例感染.结论 B超引导下的麦默通微创旋切术是一种安全微创的诊治技术,具有传统开放手术无法比拟的优点,对于乳腺多发性良性病变的肿块可彻底切除,对乳腺可疑病变能及时明确诊断,合理治疗.     

超声引导下麦默通微创旋切系统在乳腺不可触及病灶中的临床应用

目的 探讨超声引导下麦默通微创旋切系统在切除乳腺不可触及病灶中的应用价值.方法 245例共325处经超声检查的乳腺肿块患者在超声引导下麦默通微创旋切系统局部麻醉下行肿块旋切术.结果 所有患者均在超声引导下完成肿块旋切术,5处出现血肿,发生率为1.54％（5/325）.病理结果示乳腺纤维腺瘤172处;导管内乳头状瘤8处;乳腺腺病87处;纤维囊性乳腺病56处;乳腺癌2处.结论 超声引导下麦默通微创旋切系统在乳腺不可触及病灶旋切中具有定位准确、微创、美观优点.     

超声引导下麦默通微创旋切系统在治疗乳腺良性肿块中的应用

目的探讨B超引导下麦默通（Mammotome）微创旋切系统在治疗乳腺良性肿块中的应用价值。方法122例共397枚乳房良性肿块在B超引导下行麦默通微创旋切术,术后3个月随访。结果122例共397枚乳房良性肿块在B超引导下被准确完全切除,术后12例出现局部血肿,2～3月后完全吸收,5例出现皮下淤血、青紫,2月后自行消退。术后3月B超随访无原发病灶残留。结论超声引导下麦默通微创旋切系统是一项准确、有效、安全、创伤小、并发症少的乳腺微创技术,值得推广。     

超声引导下麦默通微创旋切系统在切除乳腺良性肿块中的应用

目的：探讨分析超声引导下麦默通微创旋切系统在切除乳腺良性肿块中的应用价值。方法：回顾性分析本院2012年1月-2013年6月收治的100例（202个）在超声引导下应用麦默通微创旋切系统切除乳腺良性肿块患者的临床资料。所有患者均送检病理,术后随访6~12个月,观察治疗效果。结果：100例患者共计202个乳腺肿块,其中200个为良性肿块,2个为乳腺癌灶。术中显示均完整切除所有肿块,切除单个肿块的平均时间为（9.8±2.4）min。其中8例患者出现手术并发症,手术治疗不够顺利。术后随访6~12个月,患者满意度为96%（96/100）,其中4例患者在术后6~12个月内复发,复发率为4%（4/100）。结论：超声引导下麦默通微创旋切系统在切除乳腺良性肿块中的应用价值显著,具有微创、安全、有效、美观等优点,特别适用于治疗直径在5~25 mm间的肿瘤,对于治疗直径在30 mm以上的肿块效果不佳。     

术中引流在乳腺多发良性肿块麦默通微创旋切术中的应用

目的：探讨超声引导下麦默通（Mammotome）微创旋切术处理乳腺多发良性肿块术中引流的应用及优势,总结麦默通技术的经验及注意事项。方法：回顾性分析2011年6月-2014年3月106例289处乳腺病灶行超声引导下麦默通微创旋切术的临床资料,根据手术细节的不同分成术中引流组54例患者及非引流组52例患者,观察两组治疗结果的差异。结果：106例289处乳腺病灶均完整切除,非引流组出现5例术后出血。与非引流组相比,术中引流可明显降低术后血肿的发生率,差异具有统计学意义（P〈0.05）。两组手术时间比较差异无统计学意义（P〉0.05）。结论：超声引导下麦默通微创旋切术对乳腺多发良性肿块可达到准确切除及兼顾美容的治疗目的,操作简单、安全,手术并发症少,如采用术中引流的方法更能减少术后出血的发生率,且不明显增加手术时间,值得推广。     

Minimally invasive therapy

A rapid change is taking place in the development of less invasive surgical and radiological techniques. The consequences of these changes may have considerable implications for clinical work patterns and institutional design in the next decade. Surgeons, radiologists and health economists must be prepared to recognise and react rapidly to these radical shifts in technology which are aimed at the reduction of patient morbidity and mortality.     

Alien invasive birds

A bird species is regarded as alien invasive if it has been introduced, intentionally or accidentally, to a location where it did not previously occur naturally, becomes capable of establishing a breeding population without further intervention by humans, spreads and becomes a pest affecting the environment, the local biodiversity, the economy and/or society, including human health. European Starling (Sturnus vulgaris), Common Myna (Acridotheres tristis) and Red-vented Bulbul (Pycnonotus cafer) have been included on the list of '100 of the World's Worst Invasive Alien Species', a subset of the Global Invasive Species Database. The 'Delivering Alien Invasive Species Inventories for Europe' project has selected Canada Goose (Branta canadensis), Ruddy Duck (Oxyura jamaicensis), Rose-ringed Parakeet (Psittacula krameri) and Sacred Ibis (Threskiornis aethiopicus) as among 100 of the worst invasive species in Europe. For each of these alien bird species, the geographic range (native and introduced range), the introduction pathway, the general impacts and the management methods are presented.     

Minimally invasive therapy

Minimally invasive therapy is a new and important development in medicine. With minimal disruption to the patient's body or way of life, outcomes are at least as effective and procedures are safer than conventional surgery. But there are clear implications for management on costs, and organisational and strategic issues.     

Serotype specific invasive capacity and persistent reduction in invasive pneumococcal disease

Defining the propensity of Streptococcus pneumoniae (SP) serotypes to invade sterile body sites following nasopharyngeal (NP) acquisition has the potential to inform about how much invasive pneumococcal disease (IPD) may occur in a typical population with a given distribution of carriage serotypes. Data from enhanced surveillance for IPD in Massachusetts children ≤7 years in 2003/04, 2006/07 and 2008/09 seasons and surveillance of SP NP carriage during the corresponding respiratory seasons in 16 Massachusetts communities in 2003/04 and 8 of the 16 communities in both 2006/07 and 2008/09 were used to compute a serotype specific “invasive capacity (IC)” by dividing the incidence of IPD due to serotype x by the carriage prevalence of that same serotype in children of the same age. A total of 206 IPD and 806 NP isolates of SP were collected during the study period. An approximate 50-fold variation in the point estimates between the serotypes having the highest (18C, 33F, 7F, 19A, 3 and 22F) and lowest (6C, 23A, 35F, 11A, 35B, 19F, 15A, and 15BC) IC was observed. Point estimates of IC for most of the common serotypes currently colonizing children in Massachusetts were low and likely explain the continued reduction in IPD from the pre-PCV era in the absence of specific protection against these serotypes. Invasive capacity differs among serotypes and as new pneumococcal conjugate vaccines are introduced, ongoing surveillance will be essential to monitor whether serotypes with high invasive capacity emerge (e.g. 33F, 22F) as successful colonizers resulting in increased IPD incidence due to replacement serotypes.     

Minimal invasive lumbar sympathectomy

Forty-four lumbar sympathectomies have been made on 42 patients by ROMICRO-set at the authors' department. This method--made by a specially developed lighting retractor system--ensures the same exposure as the traditional approach, but the visibility of the operative field is much better. The costs of the material character are low. Technique of the operation is discussed. Authors have got good experiences: there were no complications, postoperative pain is minimal, the time of the hospitalization is shortened. A special advantage of this new approach is that it can be even made on patients-belonging to ASA IV., and they can be operated on in epidural anesthesia. The authors recommend this new method only for those surgeons who are experienced in the technique of traditional lumbar sympathectomies.     

Bioterrorism and invasive species

The risk of dispersing invasive species, especially human pathogens, through acts of bioterrorism, cannot be neglected. However, that risk appears quite low in comparison with the risk of dispersing animal pathogens that could dramatically burden the agricultural economy of food animal producing countries, such as Australia and countries in Europe and North and South America. Although it is not directly related to bioterrorism, the intentional release of non-native species, particularly undesired companion animals or wildlife, may also have a major economic impact on the environment and, possibly, on animal and human health, in the case of accidental release of zoonotic agents.