微创旋切术与传统手术治疗乳腺炎性疾病的对比研究

摘要

Objective To investigate the clinical value of minimally invasive rotary resection in the treatment of mastitis with abscess formation. Methods A total of 93 cases with mastitis with abscess formation in our hospital from October 2010 to December 2014 were divided into two groups according to patients ’ willingness: one group was given ultrasound-guided Mammotome rotary surgery and drainage (minimally invasive group, n=45), the other underwent incision and drainage (control group, n=48).Surgical parameters, postoperative complications and patient satisfaction were compared between the two groups. Results The minimally invasive group was significantly superior to the control group in the operative time, blood loss, healing time, postoperative scar length and postoperative complications [(16.0 ±4.4) min vs.(30.6 ±6.8) min, t=-12.339, P=0.000;(8.5 ±2.3) ml vs.(12.7 ± 4.1) ml, t=-6.102, P=0.000;(10.1 ±1.9) d vs.(14.3 ±3.3) d, t=-7.595, P=0.000;(4.6 ±1.2) mm vs.(40.5 ± 11.8) mm, t=-20.913, P=0.000;8.9%(4/45) vs.25.0% (12/48), χ2 =4.232, P=0.040].Follow-up reviews at 3-6 postoperative months showed the comprehensive satisfaction of operation was significantly higher in the minimally invasive group (37/45, 82.2%) than that of control group (28/48, 58.3%) (χ2 =6.299, P=0.012). Conclusion For mastitis with abscess formation, minimally invasive rotary surgery has characteristics of minimal invasion, quick postoperative recovery, good cosmetic effects, few complications and high patients’ postoperative satisfaction.It deserves further clinical application.%目的：探讨微创旋切术治疗乳腺炎性疾病伴脓肿形成的临床价值。方法选择2010年10月～2014年12月93例乳腺炎性疾病伴脓肿形成的患者，按患者意愿分别行超声引导下麦默通旋切置管引流（微创组，n＝45）或切开引流术（对照组，n＝48）。对比2组手术相关指标、术后并发症、患者满意度等。结果微创组手术时间、术中出血、治愈时间、瘢痕长度和术后并发症发生率均明显优于对照组[（16.0±4.4）min vs.（30.6±6.8）min， t＝－12.339， P＝0.000；（8.5±2.3） ml vs.（12.7±4.1）ml， t＝－6.102， P＝0.000；（10.1±1.9）d vs.（14.3±3.3）d， t＝－7.595， P＝0.000；（4.6±1.2）mm vs.（40.5±11.8）mm， t＝－20.913， P＝0.000；8.9％（4／45） vs.25.0％（12／48），χ2＝4.232， P＝0.040]。术后3～6个月调查患者对手术效果、美容效果、术中体验的综合满意度，微创组满意率（37／45，82.2％）明显高于对照组（28／48，58.3％）（χ2＝6.299， P＝0.012）。结论对于乳腺炎性疾病伴脓肿形成，微创旋切术具有创伤小、术后恢复快、美容效果好、并发症少的特点，术后患者满意度高，值得临床推广应用。