超声引导下麦默通旋切系统对临床无法触及乳腺病变的诊断价值

目的:探讨超声引导下麦默通旋切系统在临床上无法触及的乳腺病变的诊断价值。方法:对36例患者共46个临床无法触及而超声显示的乳腺病灶行麦默通旋切手术,术中行标本冰冻切片。结果:术后病理提示:恶性病变1例,改行保乳手术,良性病变45例。术中无一例出血,术后复查无一例病灶残留,皮肤淤血1例,局部血肿1例,超声随访1～6个月未见局部复发。结论:超声引导下麦默通旋切系统适合临床无法触及乳腺病变的微创切除,具有高效、安全、定位准确、无瘢痕等优点。     

麦默通系统在乳腺良性疾病治疗中的应用26例分析

目的：探讨超声引导下麦默通系统在乳腺良性病变中的临床应用。方法：回顾性分析26例应用麦默通系统治疗患者的临床病例资料。结果：26例患者病灶均切除成功,所有患者均无感染或其他并发症,术后超声随访1～8个月,未见复发。结论：超声引导麦默通对乳腺肿块微创旋切具有定位切除准确、病理诊断率高、创伤小、操作安全,尤其适合于3 cm以下的乳腺良性肿块,是一种值得推广的微创手术方法。     

超声引导下麦默通微创旋切术在1036例乳腺肿物切除中的应用

目的探讨超声引导下Mammotome~?(麦默通)微创旋切术在乳腺肿物切除中的应用经验与价值。方法回顾性研究2014年11月至2018年5月期间,首都医科大学附属北京友谊医院1 036例患者乳腺上1 133个乳腺肿物行超声引导下麦默通微创旋切术的治疗效果。对手术一般情况、术后病理类型、术后并发症发生情况、术后3个月复查结果进行分析。结果手术治疗过程中均能清晰显示病变,引导成功率为100%,无感染,无皮肤损伤,23例出现局部血肿、133例出现局部瘀斑,局部出血发生率为13. 7%。术后3个月超声随访结果显示,6例(0. 5%)患者手术部位出现良性病变。结论超声引导下麦默通乳腺微创旋切术,具有操作方便、定位准确、创伤小、并发症少、恢复快、美观等优点,在切除乳腺肿物方面可替代传统手术模式,是值得推广的微创治疗方法。     

麦默通乳腺良性肿块微创旋切术的术中配合及护理

目的 探讨B超引导下麦默通微创旋切系统在乳腺良性肿块切除中的术中配合及护理方法。方法 由护士准备好术前手术包并在术中配合医生，在B超引导下应用麦默通系统对38例病人50个乳房良性肿块施行微创旋切术，护士在术前术后进行相应的护理。结果 所有行麦默通肿块切除术患者，术后护理得当，无手术并发症。结论 B超引导下麦默通微创旋切系统切除乳房良性肿块，操作简易、准确、安全、创伤小，受到广大女性的欢迎。     

超声引导麦默通在乳腺肿块微创旋切术中的应用

目的探讨超声引导下麦默通在乳腺肿块切除中的应用价值。方法56例经临床结合超声诊断的乳腺肿块,女性患者,在超声引导下使用麦默通行乳腺肿块微创旋切术。结果56例患者共旋切148个肿块,直径5～30min,超声均能清晰显示肿块微创旋切的全过程。术中监测和术后复查有2例2个结节未被完整切除,完整切除率98．6％。56例患者病理结果阳性率100％。结论超声引导麦默通对乳腺肿块微创旋切具有定位切除准确、病理诊断率高、创伤小、疗效好、操作简单、安全等优点,尤其适合于30mm以下的乳腺良性肿块,是一种值得推广的微创手术方法。     

超声引导下麦默通乳腺微创旋切术61例围术期护理

目的：探讨超声引导下麦默通乳腺微创旋切术患者围术期的护理方法。方法：对61例乳腺肿块患者行超声引导下麦默通乳腺微创旋切术,并给予精心围术期护理。结果：本组乳腺病灶均被准确切除,经精心围术期护理后无活动性出血、局部淤血及切口感染等并发症发生,均痊愈出院。结论：超声引导下麦默通乳腺微创旋切术是一项准确有效、安全、创伤小的微创技术,加强围术期护理是确保手术成功的关键。     

超声引导下麦默通乳腺微创旋切术61例围术期护理

目的:探讨超声引导下麦默通乳腺微创旋切术患者围术期的护理方法.方法:对61例乳腺肿块患者行超声引导下麦默通乳腺微创旋切术,并给予精心围术期护理.结果:本组乳腺病灶均被准确切除,经精心围术期护理后无活动性出血、局部淤血及切口感染等并发症发生,均痊愈出院.结论:超声引导下麦默通乳腺微创旋切术是一项准确有效、安全、创伤小的微创技术,加强围术期护理是确保手术成功的关键.     

实时三维超声引导经皮微创切除乳腺良性肿物的应用

目的探讨三维超声引导麦默通旋切系统经皮负压切除乳腺良性肿物的应用价值。方法三维超声引导对83例患者161个乳腺良性肿物行麦默通微创抽吸切除。结节最长径0．6～3．5cm，平均（1．7±O．5）cm。结果全部结节均成功引导切除，实时三维模式下穿刺旋切刀显示清晰，定位准确，但图像实时性较差。全部病例术后随访1～18个月无复发。结论实时三维超声引导麦默通旋切系统适于乳腺良性肿物（最长径≤3．5cm）的微创切除，安全、有效，短期随访无复发。有助于手术计划制订，但实时性有待进一步提高。     

B超引导下麦默通装置在乳腺微创外科中的应用

【目的】探讨B超引导下麦默通系统在乳腺微创外科中的应用价值。【方法】在B超引导下采用麦默通装置行微创旋切对36例乳腺肿瘤患者进行诊断及治疗。【结果】10例行穿刺活检,其中恶性4例,明确诊断后均行新辅助化疗。26例乳腺肿块均完整切除。术后1月B超随访无原病灶残留和复发,3例出现术后出血并发症．1～2个月后完全吸收。超声引导成功率100％。【结论】B超引导下麦默通乳腺微创旋切术是一种治疗乳腺肿瘤安全、合理、有效、符合美学观点的诊治方法。     

超声引导下运用麦默通治疗男性乳腺发育症6例的观察与护理

目的：探讨超声引导下麦默通微创旋切系统治疗男性乳腺发育症的护理方法。方法：对6例男性乳腺发育症患者行超声引导下麦默通微创旋切术,术前行心理护理,术后给予伤口护理和健康指导。结果：所有男性增生乳腺,术后护理得当,仅1例患者术后出现局部皮下淤血,经处理后痊愈,无一例发生感染及皮下积液。结论：超声引导下麦默通旋切系统切除男性增生乳腺创伤小,术后并发症少,护理简单方便。     

超声引导下Mammotome微创旋切系统在乳腺良性病变切除术中的应用

目的探讨超声引导下Marnmotome微创旋切系统往切除乳腺良性病变中的应州价值。方法86例乳腺肿瘤患者,115个乳腺肿块,经超声或X线钼靶检查,结合临床初步诊断为良性病变,在超声引导下应用Mammotome微创旋切系统治疗,同时行病理检查。结果乳腺病灶在超声引导下均被完全切除,每个肿块手术时间（20±10）min,平均旋切次数15次,皮肤切口0．25～0．4cm。1例出现切口下血肿,2个月后完全吸收,5例出现皮下淤血癍,术见感染．结论超声引导下Mammotome微创旋切乳腺良性病变,具有创伤小、并发症少、恢复快、乳房表面不留疤痕等优点,是一种值得推广的乳腺病变微创治疗方法。     

Ultrasound-guided mammotome vacuum biopsy for the diagnosis of impalpable breast lesions.

OBJECTIVES: To assess the diagnostic accuracy of ultrasound-guided mammotome vacuum biopsy in impalpable breast lesions. METHODS: Seventy-three patients who presented with impalpable breast lesions that were suspicious for malignancy at mammography and/or sonography were included in the study. In the first instance the women underwent ultrasound-guided fine-needle aspiration cytology, then, 3 days later, histological biopsy with an ultrasound-guided mammotome device. The patients with both cytological and histological diagnoses of malignancy underwent surgery; those with a negative (for malignancy) cytological diagnosis, but with a histological diagnosis of atypical hyperplasia or sclerosing adenosis, underwent surgical biopsy. RESULTS: The diagnostic accuracy of fine-needle aspiration cytology was 67.2%; the sensitivity was 86.7%, the specificity was 48.4%, the negative predictive value was 78.9% and the positive predictive value was 61.9%. In comparison, the diagnostic accuracy of histological sampling by mammotome vacuum biopsy was 97.3%; the sensitivity was 94.7%, the specificity was 100%, the negative predictive value was 94.6% and the positive predictive value was 100%. Thus there was a statistically significant difference in diagnostic accuracy between fine-needle aspiration cytology and mammotome vacuum biopsy (67.2% vs. 97.3%; chi2 test, P < 0.001). The 2.7% (2/73) failure rate of mammotome biopsy was likely to be due to an error in the positioning of the needle. The subsequent surgical biopsy proved that two cases, negative for malignancy by mammotome biopsy, were in fact malignant. CONCLUSIONS: Our data confirm the value of sonography for the diagnosis of breast carcinoma in the preclinical phase and the efficacy of ultrasound sampling using a mammotome device to confirm the diagnosis in impalpable breast lesions.     

高频超声引导Mammotome乳腺活检系统微创治疗乳腺良性肿块

目的探讨高频超声引导Mammotome乳腺活检系统微创治疗乳腺良性肿块的临床应用价值。方法对46例52个经临床及彩超诊断的乳腺良性肿块行高频超声引导下旋切治疗,对引导情况及治疗效果进行评价。结果高频超声引导成功率及显示率均为100%;34例共40个0.5cm≤直径≤2.5cm的肿块,完全切除32例共38个肿块(95.0%),8例共8个2.5cm<直径≤3.0cm的肿块,完全切除5例共5个肿块(62.5%),4例共4个直径>3.0cm的肿块,肿块完全切除0例。结论高频超声引导Mammotome乳腺活检系统微创治疗乳腺良性肿块创伤小、疗效好,尤其适用于治疗直径0.5~2.5cm的乳腺良性肿块。     

Minimal invasive complete excision of benign breast tumors using a three-dimensional ultrasound-guided mammotome vacuum device.

OBJECTIVE: The aim of this study was to evaluate the use of three-dimensional (3D) ultrasonography in the complete excision of benign breast tumors using ultrasound-guided vacuum-assisted core-needle biopsy (Mammotome). A protocol for the management of benign breast tumors is proposed. METHOD: Twenty consecutive patients with sonographically benign breast lesions underwent 3D ultrasound-guided mammotome biopsy under local anesthesia. The indication for surgical biopsy was a solid lesion with benign characteristics on both two-dimensional (2D) and 3D ultrasound imaging, increasing in size over time or causing pain or irritation. Preoperatively, the size of the lesion was assessed using 2D and 3D volumetry. During vacuum biopsy the needle was visualized sonographically in all three dimensions, including the coronal plane. Excisional biopsy was considered complete when no residual tumor tissue could be seen sonographically. Ultrasonographic follow-up examinations were performed on the following day and 3-6 months later to assess residual tissue and scarring. RESULTS: All lesions were histologically benign. Follow-up examinations revealed complete excision of all lesions of < 1.5 mL in volume as assessed by 3D volumetry. 3D ultrasonographic volume assessment was more accurate than 2D using the ellipsoid formula or assessment of the maximum diameter for the prediction of complete excision of the tumor. No bleeding or infections occurred postoperatively and no scarring was seen ultrasonographically on follow-up examinations. CONCLUSIONS: Ultrasound-guided vacuum-assisted biopsy allows complete excision of benign breast lesions that are 相似文献   

超声引导Mammotome旋切真空抽吸系统切除乳腺包块的临床价值

目的探讨超声引导Mammnotome旋切抽吸微创系统在乳腺包块切除及活检中的临床价值。方法临床触征和超声检查发现乳腺包块患者100例（共135个包块）,包块直径0．4～3．5cm,超声引导Mammotome旋切抽吸系统行包块切除术,切除的组织条行病理检查。结果超声引导Mmmnotome真空旋切抽吸系统对135个病灶准确定位,所有病灶均取得组织,病理结果乳腺癌9例,其中4例为浸润性导管癌,其余均为良性病灶。结论Mammnotome旋切抽吸系统适用于实性肿块活组织检查和良性肿块切除,术后并发症少,超声定位准确,操作简单,有较高的临床实用价值。     

超声引导下穿刺活检在乳腺非肿块样病变诊断中的应用价值

目的探讨超声引导下穿刺活检在乳腺非肿块样病变中的诊断价值。 方法选取2017年1月至2018年12月杭州市第一人民医院超声科经超声检查评估为乳腺影像报告与数据系统（BI-RADS）4a类及以上的乳腺非肿块样病变患者93例,共计93个病灶。所有病变均行超声引导下穿刺活检,并经手术病理证实。应用四格表计算超声引导下穿刺活检对乳腺非肿块样病变的诊断效能。 结果手术病理结果提示,恶性病灶47个,良性病灶46个。超声引导下穿刺活检结果提示恶性病灶43个,良性50个。穿刺活检漏诊4个恶性病灶,术前超声均提示为BI-RADS 4b,术后病理证实3例为导管原位癌和1例为浸润癌。超声引导下穿刺活检诊断乳腺非肿块样病变的敏感度为91.4%（43/47）,特异度为100.0%（46/46）,假阴性率为8.6%（4/47）,诊断准确性为95.7%（89/93）。 结论超声引导下穿刺活检对乳腺非肿块样病变的诊断存在一定的假阴性率,但敏感度、特异度及准确性均较高,具有良好的诊断价值。     

超声引导下Mammotome微创旋切术在乳腺肿瘤中的应用

目的探讨超声引导下Mammotome微创旋切术在乳腺肿瘤中的应用价值。方法对196例285个乳腺肿瘤进行超声引导下Mammotome微创旋切术。结果 285个乳腺肿瘤均被超声引导下Mammotome微创旋切术完全切除,每个肿瘤平均旋切13次(5～28次),手术时间30min(15～60min)。2例患者术后并发皮下血肿,余无并发症。手术瘢痕长2.5～5.0mm且较隐蔽。术中冰冻切片报告乳腺纤维瘤175例,乳腺腺病12例,导管内乳头状瘤6例,导管内原位癌3例。196例均应用超声检查进行术后随访,均未提示局部复发。结论应用Mammotome微创旋切系统切除适当大小乳腺肿瘤,可完全切除肿瘤并明显减少术后瘢痕,达到美容美观效果,并发症少,且可早期诊断可疑恶性肿瘤。     

超声引导下乳腺刀在乳腺肿块切除中的评价

目的探讨超声引导乳腺刀(mammotone)微创旋切系统对乳腺肿瘤治疗的评价。方法对55例71个乳腺病灶进行了超声引导下旋切术。所有病灶均行超声术前诊断、定位,术中引导旋切刀刺入并监测切割过程,术后明确病灶被切除。结果71个乳腺病灶被切除,1例因术后血肿于5h后开放手术止血。术后随访原病灶消失。71个病灶中3个病理诊断为乳癌(4.2%),68个为良性病变(95.8%)。结论乳腺刀微创旋切术可早期诊断和治疗乳腺病变,是安全有效的方法,超声能准确定位并引导旋切刀进行切割,可作为首选的引导方法。     

Complete extirpation of benign breast lesions with an ultrasound-guided vacuum biopsy system.

OBJECTIVES: To investigate whether ultrasound-guided vacuum biopsy (VB) with curative intent is suitable for the complete extirpation of selected sonographically detectable benign lesions of the breast, and to establish the limitations of the method with regard to lesion size and complications, the extent of scar formation and the prognostic value. METHODS: One hundred and nine patients underwent hand-held, ultrasound-guided VB (8G or 11G needle) between June 2000 and September 2003. Of these, 45 (41%) women underwent ultrasound-guided extirpation of 46 lesions, and 42 women with 43 lesions were followed up clinically and sonographically for an average of 5.9 months. The complete extirpation rate, residual lesions, and patient satisfaction with the intervention were evaluated. RESULTS: Removal of all sonographic evidence of lesions (median diameter, 13 mm) was achieved in 86% of cases (8G needle, 80%; 11G needle, 89%). 19% of the patients had suspected scar formation at the biopsy site. A palpable lesion in the breast could be removed by VB in 90% of cases. None of the patients developed infections and there were no hemorrhages requiring intervention, or damage to the skin or chest wall. A total of 95% of the patients stated that they would prefer this approach to open excision for possible future intervention. CONCLUSIONS: VB is an ambulatory procedure associated with a low degree of pain. It has a high degree of patient acceptance and, as a minimally invasive biopsy technique for benign lesions, is a good alternative to open excision. The rate of complications is low and is similar to that observed with conventional microbiopsy.