发光细丝在病理性乳头溢液手术中的应用

目的探讨自制发光细丝插入病变乳腺导管标记的方法在病理性乳头溢液手术中的作用。方法将2009年5月至2012年10月在安徽医科大学附属省立医院手术治疗的32例乳头溢液患者随机分为两组：改良手术组（将发光细丝经溢液乳孔插入病变乳腺导管）14例，传统手术组（乳管内用高浓度亚甲蓝染色）18例，分析两组手术野的污染、微小病变的识别及术后病理结果等情况，对数据采用成组设计资料的t检验等方法分析。结果传统手术组亚甲蓝外溢污染手术野8例（44．4％，8／18），而改良手术组无一例手术野污染，两组比较差异有统计学意义（P=0．004）；传统手术组的手术时间为（38±9）min，改良手术组为（29±10）min，两组比较差异有统计学意义（t=2．674，P=0．012）。32例乳头溢液患者的病变导管均被手术切除；所有患者均获得病理确诊，且无并发症发生。结论改良法能准确定位病变乳管，使手术野清楚、操作方便、手术时间缩短。发光细丝对乳头溢液患者有较好的应用价值。

Application of light-emitting filament in pathologic nipple discharge

Objective To investigate the application value of light-emitting filament in the treatment of pathologic nipple discharge. Methods From May 2009 to October 2012, 32 cases of nipple discharge were randomly divided into improved surgery group （14 cases; light-emitting filaments were inserted into the mammary duct through discharge hole） and conventional surgery group （18 cases; high concentration of methylene blue was used for staining in duct）. The data on surgical field contamination, identified small lesions and postoperative pathologic results were analyzed with student＇ s t test. Results Eight patients were observed with methylene blue contaminated field in conventional surgery group（44.4% ,8/18 ） , none with surgical field contamination in improved surgery group and the difference was statistically significant （P = 0. 004 ）. The operative time was （38±9） rain in conventional surgery group, （29± 10） min in improved surgery group and the difference was statistically significant （t = 2. 674, P = 0. 012 ）. The duct lesions were resected in 32 cases of nipple discharge. All patients were pathologically confirmed, and no complications occurred. Conclusion The light-emitting filament can accurately detect the duct lesions and visualize the surgical field so as to bring the convenience and reduce the operative time, which shows good application value in the patients with nipple discharge.