超声引导下导丝定位在乳腺癌保乳手术中的应用价值

摘要

Objective:To study ultrasound-guided wire localization and intraoperative ultrasoundguided position and application value of breast-conservingsurgery in breast cancer. Methods:The samples with single lesion of breast cancer,who underwent breast-conserving surgery were selected,115 patients were with preoperative ultrasound guided wire position and 103 cases with intra-operative ultrasound localization. Compare the differences between the two groups among the position time+operation time,the positive rate of the lesion margin,specimen removal/lesion tissue volume and postoperative complications. Results:The two kind of operations were performed successfully. Guided wire location average positioning time+operation time was 40min,the average time for intraoperative ultrasound was47 minutes. There were statistical significance differences between the two groups(P<0. 01). Guided wire location in 115 patients with positive margin postoperative pathology were 26 case(22. 61%),and intraoperative ultrasound in 103 cases were 15 cases (14. 56%). There were no significant differences between them(P>0. 05). Both of the weight of the specimen and resection index were significantly lower in the needle localization group than in the ultra-sonic position group(P<0. 01). There were no statistical significances in complications between the two groups. Con-clusion:The ultrasound-guided wire position has higher accuracy and shorter operation time during the operation of breast cancer and it can avoid much more resection of normal breast tissue. Additionally,wire localization has less in-fluence on the breast shape.%目的：：对比分析超声引导下导丝定位与术中超声定位在乳腺癌保乳手术中的临床应用价值；方法：收集我院2009年1月-2013年12月保乳手术的乳腺癌患者,术前行超声引导下导丝定位者115例,行术中超声定位者103例,所有患者均为单发。比较两种定位方法的定位时间+手术时间、术后标本切缘阳性率、标本切除量/病灶组织量及术后并发症等方面的差异。结果：两组定位病例所有患者均全部定位成功,行导丝定位者平均定位时间+手术时间为40min,行术中超声者平均时间为47分钟,两者对比差异有统计学意义( P<0.01)；行导丝定位115例患者术后病理切缘阳性者为26例(22.61%),术中超声的103例患者术后病理切缘阳性率15例(14.56%),两者比较无统计学意义(P>0.05)。标本切除量/病灶组织量前者(71)小于后者(95),差异有统计学意义(P<0.01)；两者在术后并发症方面无统计学意义。结论：乳腺癌保乳术前超声引导下导丝定位有较高的定位准确率,并且能够明显缩短手术时间,减少正常乳腺组织的过多切除,减少了对乳腺外形的影响。