乳腺良性病变患者微创旋切术与传统手术治疗效果对比观察

目的:对乳腺良性病变患者微创旋切术与传统手术治疗效果进行深入的分析和研究.方法:收集我院的90例乳腺良性病变患者,随机分为A组和B组,对A组患者使用传统手术进行治疗,对B组患者使用微创旋切术进行治疗,然后对比两组患者治疗后的术中出血量、手术时间、愈合时间等指标.结果:B组患者患者的术中出血量、手术时间、愈合时间明显小于A组患者,差异有统计学意义,P<0.05.结论:微创旋切术在治疗乳腺良性病变方面有着十分良好的效果,通过微创旋切术可以十分有效地减少患者的术中出血量和手术时间,促进患者伤口的早日愈合,因此可以进行临床推广应用.     

消癖散治疗乳腺增生病228例

乳腺增生病为临床常见病 ,尤以 2 0～ 45岁女性多见。 1997年以来 ,我们自拟中药方剂消癖散治疗乳腺增生病 2 2 8例 ,疗效较满意 ,现报告如下。1　对象和方法1.1　方法　 2 2 8例乳腺增生病患者中 ,年龄最小 19岁 ,最大 5 4岁 ,其中 19～ 2 0岁 3例 ,2 1～ 30岁 49例 ,31～ 40岁 12 3例 ,41～5 0岁 47例 ,5 1～ 5 4岁 6例。病程最短 3个月 ,最长 8年 ,临床上均有不同程度的乳房胀痛或触痛 ,表现为周期性 ,多发于月经来潮前 ,部分为持续性且在月经前加重。所有病例均经详细询问病史及健康状况 ,常规进行乳房检查 ,利用Ｘ线、近红外线扫描等检…     

乳腺增生病38例临床疗效观察

乳腺增生病是女性常见的乳腺疾病 ,中医称乳癖。笔者近几年来用“小叶增生方”治疗 3 8例乳腺增生病 ,获得较好疗效 ,现报告如下。1　资料和方法1.1　临床资料　本组 3 8例均符合诊断标准 ,用组织病理切片和Ｘ线钼靶摄片 ,排除乳腺纤维瘤及乳腺癌等。全部病例均为女性 ,其中未婚 5例 ,已婚 3 3例 ,19～ 3 0岁 8例 ,3 1～ 40岁 2 1例 ,41～ 5 0岁 9例 ,病程在 1年以上者 2 2例 ,2～ 3年者 11例 ,3年以上者 5例。临床表现为乳痛、乳胀、乳房肿块。有乳痛者 3 1例 ,其中月经前加重者 2 3例 ,生气、疲劳而加重者 8例 ,余无明显诱因。乳痛表现为…     

早期开展麦默通乳腺良性病变微创旋切手术的并发症及防治对策

目的分析早期开展麦默通乳腺微创旋切手术并发症产生的原因、探讨其防治对策。方法总结我院开展B超指导下麦默通乳腺微创旋切手术29例、切除病灶87个的临床资料,分析所发生的并发症的经验教训、处理措施及预防对策。结果29例患者在B超监视下共切除可疑病灶87个;术中出血3例,切破皮肤1例,经处理全部治愈;3例术后局部皮肤出现轻微瘀斑,未行特殊处理,均在2wk内皮肤恢复正常;有部分患者的针道创伤,短期内在乳腺表面扪及呈条索状改变;所有病例术后未出现明显活动性出血、血肿、感染等并发症。结论B超指导下麦默通乳腺微创切除乳腺良性病变,具有创伤小、并发症少、恢复快、乳房表面不留疤等优点,是一种值得推广的乳腺病变微创治疗方法。     

早期开展麦默通乳腺良性病变微刨旋切手术的并发症及防治对策

目的 分析早期开展麦默通乳腺微创旋切手术并发症产生的原因、探讨其防治对策.方法 总结我院开展B超指导下麦默通乳腺微创旋切手术29例、切除病灶87个的临床资料.分析所发生的并发症的经验教训、处理措施及预防对策.结果 29例患者在B超监视下共切除可疑病灶87个;术中出血3例,切破皮肤1例,经处理全部治愈;3例术后局部皮肤出现轻微瘀斑,未行特殊处理,均在2 wk内皮肤恢复正常;有部分患者目的 针道创伤,短期内在乳腺表面扪及呈条索状改变;所有病例术后未出现明显活动性出血、血肿、感染等并发症.结论 B超指导下麦默通乳腺微创切除乳腺良性病变,具有创伤小、并发症少、恢复快、乳房表面不留疤等优点,是一种值得推广的乳腺病变微创治疗方法.     

卵巢癌术后化疗后乳腺转移1例

本文报告1例卵巢癌术后化疗后乳腺转移病例.     

麦默通乳腺良性肿块旋切术后血肿的临床分析

目的 探讨影响麦默通微创旋切术切除乳腺良性肿块后血肿形成的主要因素.方法 190例患者根据术后肿块切除位置有无发生血肿分为血肿组(18例)和无血肿组(172例),观察肿块的大小、同侧乳腺一次手术切除的肿块数目、术中出血量、手术时间、术后疼痛时间.结果 血肿组与无血肿组术中出血量、手术时间、术后疼痛时间比较差异无统计学意义,但肿块直径、一次手术切除肿块数目比较差异有统计学意义(P<0.05).肿块共263枚均经病理证实:纤维腺瘤136例,乳腺囊性增生病35例,单纯囊肿19例.术后近期血肿15例,术后远期血肿3例.结论 肿块直径大(>3 cm)、同侧乳腺一次切除肿块数目多,是术后形成血肿的高危因素.     

乳腺良性疾病微创入路手术疗效研究

目的探讨应用微创入路手术治疗乳腺良性肿瘤的方法和效果。方法选取我院收治的乳腺良性肿瘤患者112例,将其随机分为微创入路手术组与传统切口手术组,对2组患者手术方式、术中术后情况,乳晕区感觉、乳房外观、患者的满意度等进行比较。结果微创入路手术组患者术中出血、切口愈合、并发症、患者满意度等方面均优于对照组,其差异有统计学意义(P<0.05)。结论应用微创入路手术治疗乳腺良性肿瘤,获得良好疗效同时能减少术中出血,有利于切口愈合,术后恢复快、并发症少,患者满意度高,适合在临床推广应用。     

乳腺下缘切口经乳腺后间隙入路术对乳腺多发性纤维腺瘤患者手术效果、术后切口瘢痕评分及外观满意度的影响

目的:探讨治疗乳腺多发性纤维腺瘤患者使用乳腺下缘切口进乳腺后间隙入路术的效果.方法:选取我院2015年6月到2016年12月治疗的乳腺多发性纤维腺瘤患者90例,随机分为对照组和观察组,每组45例.对照组使用常规手术治疗,观察组使用乳腺下缘切口乳腺后间隙入路术治疗.观察两组患者手术效果、术后切口瘢痕评分,并调查外观满意度.结果:所有患者均顺利完成手术,且观察组患者的手术效果优于对照组患者;术后3个月调查患者对术后切口瘢痕的评分和外观满意度,与对照组患者相比明显较低,两组数据比较,差异具有统计学意义,P<0.05.结论:使用乳腺下缘切口经乳腺后间隙入路术治疗乳腺多发性纤维腺瘤患者,具有理想中的手术效果,且术后切口瘢痕较为理想,术后外观也较为满意.     

安珂微创旋切术治疗乳腺良性肿物患者的临床疗效研究

目的探讨安珂微创旋切术治疗乳腺良性肿物的临床疗效。方法选取我院2016年7月至2018年6月拟行外科手术治疗的122例乳腺良性肿物患者,根据手术方式分为A组和B组各61例。A组采用安珂微创旋切术,B组采用常规开放手术。比较两组患者的手术指标、术后并发症及疼痛情况、满意度。随访1年,观察术区吸收情况。结果与B组比较,A组的切口长度、切口愈合时间、住院时间、手术时间较短,术中出血量及VAS评分较低(P均<0.05)。A组的并发症发生率明显低于B组(P<0.05)。A组术后满意度明显高于B组(P<0.05)。A组术区吸收时间短于B组(P<0.05)。结论安珂微创旋切术治疗乳腺良性肿物的效果显著,并发症少且患者满意度高,值得临床推广应用。     

Pathology of benign breast disease

A wide spectrum of benign changes may occur within breast tissue. These inlcude non-neoplastic conditions such as fibrocystic change and benign neoplasms (tumours). Conditions such as fibrocystic change are very common in middle-aged and elderly women, but vary enormously in degree and extent between individuals. Fibroadenomas are common causes of benign breast masses in young women. Benign breast conditions may clinically simulate malignancy and therefore result in the requirement for pathological examination of the tissue as part of ‘triple assessment’ (i.e., the diagnostic process for patients with potential breast disease). It is therefore essential that pathologists can identify these benign conditions accurately. Benign breast disease may not require surgical treatment over and above that needed to confirm the diagnosis, but some forms of cellular change (e.g. florid epithelial hyperplasia, radial scar, intraduct papilloma) may be associated with co-existent malignancy (i.e. breast cancer) and/or an increased risk of subsequent malignancy.     

Methylxanthines and benign breast disease

The relation between methylxanthine consumption and biopsied benign breast disease was investigated by using data from a case-control study which included 1,569 cases and 1,846 controls identified between 1973 and 1980 through a nationwide screening program. There was no evidence of an association between methylxanthine consumption and benign breast disease in the total study population. When histologic types of benign breast disease were examined, there were no trends in risk according to methylxanthine consumption among the 813 cases with fibrocystic disease, the 508 cases for whom detailed pathology data were not available, the 172 cases with benign neoplasms, or the 156 cases with other benign conditions. When cases with fibrocystic disease were examined according to presence of atypia, hyperplasia, sclerosing adenosis, or cysts, there was, again, no association between methylxanthine consumption and risk of disease. In addition, no relation was found between methylxanthine consumption and menstrual breast tenderness among premenopausal women with fibrocystic disease or unknown conditions.     

300例良性前列腺增生腔内手术后恢复期的观察及随访

目的对300例良性前列腺增生腔内手术后的患者进行3~6个月的观察与随访。方法采用自编定式问卷调查良性前列腺增生腔内手术后患者的恢复过程、并发症、排尿现状以及手术对性欲、性能力的影响等。结果三种模式的前列腺腔内手术后,血尿持续时间与尿痛持续时间比较差异无统计学意义(P>0.05);但术后有明显脱痂过程的例数比较,前列腺气化(TVP)组多于气化 电切(TVP TURP)组和等离子气化电切(PKRP)组(P<0.05)。大于半数的术前有性功能的患者认为前列腺腔内手术对性欲有影响,其原因多为心理因素;术后6个月后约93.1%的患者恢复了正常性生活。结论大多数的手术并发症发生在术后1~3个月内,早期积极处理,有利于患者的顺利康复。腔内泌尿外科医生应当重视前列腺腔内手术后恢复期的观察与随访。     

Oral contraceptives and benign breast disease

In 1980 a questionnaire was mailed to 726 nurses who had previously entered a study of breast disease in the late 1940s and 1950s; 665 responded. Between the ages of 30 to 49 years, 137 reported detecting their first signs of benign breast disease and 76 reported receiving their first biopsy for these signs. Long-term oral contraceptive usage reduced the risk of developing signs of benign breast disease and the risk of biopsy for these signs. The potential bias due to the effect of prior benign breast disease on the prescribing practices for oral contraceptives was minimized by considering oral contraceptive usage prior to detecting the first signs of benign breast disease.     

Risk factors for benign proliferative breast disease

BACKGROUND: As part of a nested case-control study of benign proliferative breast disease (BPBD) conducted within the cohort of women participating in the Alberta breast screening programme, an analysis of all women who had a benign breast biopsy between 1990 and 1995 was undertaken to identify the epidemiological risk factors for BPBD. METHODS: The breast biopsies of all eligible women were re-reviewed by a panel of four pathologists using Page's classification for benign breast disease. Cases were 165 women whose biopsies, upon review, showed benign breast tissue changes ranging from sclerosing adenosis to atypical ductal hyperplasia. Controls were 217 women whose biopsies showed no evidence of any proliferative or neoplastic changes. In-person interviews were conducted with all study subjects. RESULTS: Women with >/=25% fibroglandular breast tissue density, as compared to women with <25% density, experienced nearly a doubling in risk of BPBD (OR = 1.91, 95% CI : 1.24-2.94). All other possible risk factors examined were not associated with BPBD. CONCLUSION: This study suggests that fibroglandular tissue density may be a risk factor, or marker, for increased risk of BPBD.     

Cigarette smoking and benign breast disease.

The association between cigarette smoking and the occurrence of benign breast disease was assessed in a hospital-based case-control study conducted in Connecticut during 1979-81. Current smokers, but not former smokers, were at reduced risk for all benign breast diseases. The odds ratios associated with current smoking were 0.7 (95% confidence intervals = 0.6, 0.9) for fibrocystic breast disease, 0.6 (95% confidence intervals = 0.5, 0.9) for fibroadenoma, 0.6 (95% confidence intervals = 0.4, 1.0) for fibrocystic breast disease concomitant with fibroadenoma, and 0.6 (95% confidence intervals = 0.5, 0.9) for other benign breast disease. Adjustments for potentially confounding variables, including indices of medical care utilisation, affected these odds ratios only slightly. There was no convincing evidence of an association, either negative or positive, between current cigarette smoking and the degree of epithelial atypia of the fibrocystic lesions. However, the negative association between fibrocystic disease and current cigarette smoking was strongest for atypical lobular hyperplasia, which in turn has been associated with a particularly elevated risk of subsequent breast cancer.     

The effect of nutritional status on morbidity after elective surgery for benign gastrointestinal disease

The effect of nutritional status on the morbidity and mortality of major gastrointestinal surgery for benign disease was studied in 32 patients. Malnutrition was defined as a serum albumin less than 3.5 g/dl and a recent weight loss greater than 10%, in addition to any two of the following: weight for height, midarm circumference or triceps skin-fold thickness less than 10th percentile. The morbidity and mortality in the 17 malnourished patients was 59% and 29%, respectively, compared with 20% and 7% in 15 well-nourished patients matched for age and operative procedure (p less than 0.05). After operation, the mean duration of inadequate oral nutritional intake period (IONIP, defined as a caloric intake greater than 60% requirement) was 11.9 days +/- 2.9 (SEM) in well-nourished patients compared with 30.5 days +/- 3.7 in the malnourished group. The longer IONIP in malnourished patients was a consequence of the higher morbidity in this group, thus warranting the consideration of supportive (postoperative) parenteral nutrition in malnourished patients who undergo major gastrointestinal surgery for benign disease.