不同手术方案治疗乳腺多发纤维腺瘤的临床疗效

刘兰，张朝锋，张郁，罗欢，爨军宁

宝鸡市妇幼保健院乳腺科，陕西 宝鸡，721000

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摘要：

目的 探讨乳腺多发纤维腺瘤的手术方法和临床疗效。方法 对我院收治的 763例乳腺多发纤维腺瘤患者的临床资料进行回顾性分析。根据手术方法不同，将接受开放手术（OS）治疗的 368例患者作为 OS组，将接受麦默通（MMT）治疗的 395例患者作为 MMT 组。比较两组患者的手术时间、术中出血、包块切除情况、术后并发症、住院时间及术后复发情况。结果 与 OS组比较，MMT 组术中出血量更多、手术时间及住院时间明显更短、包块全部切除率及术后出血或血肿发生率更高（P＜0.05）。两组术后 2年复发率比较，差异无统计学意义（P＞0.05）。结论 乳腺多发纤维腺瘤的患者采取 MMT 真空辅助乳房包块微创旋切术具有全部切除率高、手术时间及住院时间短的优点，与 OS相比，术中出血量和术后并发症较多。如果不考虑美容需要，仅从医学治疗的必要性出发，乳腺多发纤维腺瘤是否需要全部手术切除值得商榷。

关键词： 乳腺多发纤维腺瘤；麦默通；开放手术

中图分类号：R655.8文献标志码：A文章编号： 2096-1413(2018)09-0070-03

Clinical efficacy of different surgical schemes in the treatment of
multiple fibroadenoma of breast


LIU Lan,ZHANG Zhao-feng,ZHANG Yu,LUO Huan,CUAN Jun-ning *
(Galactophore Department, Baoji Maternal and Child Health Hospital,Baoji 721000,China)



ABSTRACT: Objective To explore the surgical methods and treatment effectiveness of multiple fibroadenoma of the breast. Methods The clinical data of 763 patients with multiple fibroadenoma of the breast admitted in our hospital were retrospectively analyzed.According to different surgical methods, 368 patients who received open surgery(OS)were selected as the OS group,and another 395 patients who accepted Mammotome surgery (MMT)were selected as the MMT group.The operation time,intraoperative bleeding, mass resection,postoperative complications,hospital stays and post operative recurrence were compared between the two groups.Results Compared with the OS group,there were more intraoperative bleeding,shorter operation time and hospital stays,higher mass resection rate and post operative hemorrhage orhematoma rate in the MMT group (P＜0.05).There was no significant difference in recurrence rate between the two groups (P>0.05).Conclusion For patients with multiple fibroadenoma of the breast, MMT surgery has higher mass resection rate,less operation time,shorter hospitali stays compared with the OS,but has higher intraoperative bleeding and post operative complications. If the need for beauty is not considered,only from the point of view of the necessity of medical treatment,the necessity of total resection of multiple fibroadenoma of the breastis worth discussing.
KEYWORDS: multiple fibroadenoma of the breast; Mammotome; open surgery
 

参考文献：
[1] 马云帆,范梦颖,陈克能.肺鳞癌与肺腺癌的免疫组化指标的诊断及预后意义 [J].中国肺癌杂志 ,2014,17(6):506-510.
[2] LIOTTA LA,STETLER -STEVENSON W G.Tumor invasion andmetastasis:an imbalance ofpositive and negative regulation[J].CancerRes,1991,51(18 suppl):5054s-5059s.
[3] STETLER -STEVENSON W G,HEW ITT R,CORCORAN M.Matrixmetalloproteinasesand tumorinvasion:from correlation and causalitytotheclinic[J].Semin CancerBiol,1996,7(3):147-154.
[4]CHAMBER AF,MATRISIAN LM.Changing views ofmatrix metalloproteinasein metastasis[J].JNatlCancerInst,1997,89(17):1260-1270.
[5]JOHNSON LL,DYER R,HUPE DJ.Matrix metalloproteinases[J].CurrOpin Chem Biol,1998,2(4):466-471.
[6]SUZUKIM,LIZASA T,FUJISAW A T,etal.Expression ofmatrix metalloproteinasesand tissue inhibitorofmetalloproteinasesin nonsmallcelllungcancer[J].Invasion Metastasis,1998,18(3):134-141.
[7]THOMAS P,KHOKHA R,SHEPHERD FA,etal.Differentialexpression ofmatrix metalloproteinases and theirinhibitors ofmetalloproteinasesin nonsmallcelllungcancr [J].JPathol,2000,190(2):150-156.
[8]OU SH,ZELL JA.Carcinoma NOS is a common histologic diagnosisand is increasing in proportion among non-smallcelllung cancerhistologies[J].JThoracOncol,2009,4(10):1202-1211.
[9]TRAVIS W D,BRAMBILLA E,NOGUCHI M,etal.Internationalassociation forthe study oflung cancer/American thoracic society/European respiratory society international multidisciplinary classification
oflungadenocarcinoma[J].JThoracOncol,2011,6(2):244-285.
[10]RIGHI L,GRAZIANO P,FORNARI A,et al.Immunohistochemicalsubtyping ofnonsmallcelllung cancer nototherwise specified infine-needle aspiration cytology:a retrospective study of103 cases with surgicalcorrelation[J].Cancer,2011,117(15):3416-3423.
[11] 曹立明,杨红忠,胡成平.MMP-2 和 MMP-9 在非小细胞肺癌中的表达及临床意义 [J].中国肺癌杂志 ,2003,6(6):484-487.
[12] 孟秀香,刘丹丹,聂慧玲 , 等 .Bmi-1 与 MMP-2 在肺腺癌组织中的表达及临床意义 [J].中国实验诊断学 ,2013,17(9):1587-1589.
[13] 梅同华,罗彬,马英.肺癌患者肺组织 MMP-2 、 MMP-7 和 TIMP-2表达及意义 [J]. 第三军医大学学报 ,2004,26(16):1491-1493.