乳管内窥镜对乳头溢液的诊治价值

目的:评估超细乳管内窥镜(简称"乳管内窥镜")对有乳头溢液症状患者的诊断和治疗价值。方法:对有乳头溢液患者行乳管内窥镜检查,分析有乳头溢液症状患者的乳管内表现,并进一步治疗。结果:123例有乳头溢液的患者中,乳腺导管炎63例,乳腺导管扩张症30例,乳腺导管内乳头状瘤或瘤病26例,导管内癌3例,乳头皮脂腺囊肿并感染1例。乳腺导管炎、乳腺导管扩张症给予乳管内药物(地塞米松和庆大霉素)灌注1次,随访1~18个月,78例(83.9%)停止溢液。26例乳腺导管内乳头状瘤或瘤病患者和3例导管内癌患者给予手术治疗,病理结果与乳管镜检查诊断符合率达93.1%(27/29)。1例乳头皮脂腺囊肿并感染患者给予消炎后手术治疗。结论:乳腺导管镜是诊断有乳头溢液症状的乳腺导管内乳头状瘤和导管内癌的有效手段。应用乳腺导管镜对炎性乳管进行冲洗灌注治疗,临床效果好。

Diagnoses and treatment of nipple discharge disease by fiberoptic ductoscopy

Objective:To evaluate the role of fiberoptic ductoscopy in diagnosis and treatment of nipple discharge disease.Methods:Fiberoptic ductoscopy was performed to patients with nipple discharge to analyze the characteristics of fiberoscopy ductscopy and the further treatment.Results:Among the 123 cases of patients with nipple discarge, 63 cases were diagnosed as mammary duct inflammation, 30 cases were diagnosed as mammary duct ectasia, 26 cases were related single or multiple papilloma, early cancer were 3 cases and one case was sebaceous cyst with infection. Mammary duct inflammation and ectasia were treated with dexamethasome and gentamycin once, and 78 cases (83.19%) were recovered by keepting tract 1~18 months. The patients with papilloma and early cancer were admitted in hospital for surgery. The pathological dignoses were matched with that of fiberoptic ductscopy for 27 cases (93.1%). One case of sebaceous cyst with infection was removed by surgery after anti-infection.Conclusion:Fiberoscopy ducttoscopy is an effective technique in diagnosing breast intraductal neoplasm with nipple discharge. Local drug perfusion in breast duct is an effective method to inflammatory nipple discharge.