156例单孔透明色乳头溢液诊治分析

目的分析156例单孔透明色乳头溢液的纤维乳管镜诊治效果。方法回顾性分析156例单孔透明色乳头溢液患者的临床资料,患者均行纤维乳管镜检查,并予以局部冲洗,对反复冲洗仍然存在乳头溢液的患者行纤维乳管镜辅助定位下病变乳管切除术。观察156例患者纤维乳管镜下表现及随访情况。结果156例患者均为一次置入纤维乳管镜,无反复扩管过程。其中,132例(84.62%)患者临床表现为:管腔内可见黄白色絮状物,导管相对扩张,管腔通畅,管腔内无隆起改变,管腔内未见明显占位病变;24例(15.38%)患者临床表现为:管腔内可见金属样絮状物渗出,管腔阻塞,部分病例管腔可见明显隆起改变及局灶占位病变。156例患者中,130例患者行纤维乳管镜检查诊断为乳管炎,并行病变乳管冲洗后,随诊1年,无乳头溢液复发,治愈率为83.33%(130/156);26例患者经反复冲洗无效后行病变乳管切除术,术后病理诊断为:乳管扩张19例(12.18%),乳管内乳头状瘤7例(4.49%),术后随访1年,25例患者未见乳头溢液,1例患者再次出现乳头溢液,反复冲洗无效后行病变乳管切除术,对复发性乳头溢液的治愈率为96.15%(25/26)。结论纤维乳管镜技术在局部乳管冲洗治疗及手术定位中具有重要积极作用。

Diagnosis and treatment of 156 cases of single-hole transparent nipple discharge

Objective To analyze the diagnostic effect of single-hole transparent nipple discharge treated by fibrolactoscopy.Methods The clinical data of 156 patients with single-hole transparent nipple discharge was retrospectively analyzed.All patients underwent fibrolactoscopy and local irrigation.Fibrolactoscopy-assisted localized pathological breast duct resection for patients who still have nipple discharge after repeated flushing.Performance and follow-up of patients with fibrolactoscopy was observed.Results All the 156 patients were implanted with fibrolactoscopy at one time without repeated tube expansion.Among them,132 patients(84.62%)had clinical manifestations:yellow and white flocculent matter was seen in the lumen,the catheter was relatively dilated,the lumen was unobstructed,there was no elevation change in the lumen,and no obvious occupying lesions were found in the lumen.The clinical manifestations of 24 patients(15.38%)were exudation of metal-like flocs in the lumen,obstruction of the lumen,and obvious elevation changes and focal mass lesions in some cases.Among the 156 patients,130 patients were diagnosed with mastitis by fibrolactoscopy.After washing the diseased ducts for 1 year,there was no recurrence of nipple discharge,and the cure rate was 83.33%(130/156).26 patients underwent pathological mastectomy after repeated irrigations fails,and 19 cases(12.18%)were diagnosed as dilated ducts and 7 cases(4.49%)had intrapapillary papilloma.After 1 year follow-up,25 patients had no nipple discharge,and 1 patient had nipple discharge again.Repeated irrigation was not effective and the cure rate of recurrent nipple discharge for recurrent was 96.15%(25/26).Conclusion Fibrolactoscopy has an important positive role in local breast irrigation and surgical positioning.