目的分析乳腺真空辅助旋切术后并发血肿的预后及其影响因素,为临床治疗提供借鉴。资料与方法纳入行超声引导下乳腺真空辅助旋切术的280例患者共切除486个结节,观察术后手术创区血肿的发生情况及其影响因素。结果 486个结节均完全切除,术后24 h复查47个手术创区可见直径≥1.0 cm的血肿,术后6个月基本吸收完全。对血肿的发生情况进行分析发现,结节最大径≥2.5 cm者、同时切除≥2个结节者、结节位于乳晕深部或腺体边缘者、乳房体积较大且较松弛者、月经期手术者、术后有效加压时间〈12 h者、术中未使用止血药物者的血肿发生率明显增高(P〈0.05或P〈0.01)。结论真空辅助旋切技术能对乳腺良性占位性病变进行有效切除,术后并发血肿与结节大小、部位、切除数目、乳房形态、月经期手术、术后有效压迫时间及术中使用止血药等因素有关。
Purpose To investigate the prognosis and influencing factor of hematoma complicated from ultrasonography-guided EnCor vacuum-assisted breast biopsy system in minimally invasive surgery for breast lesions, and to provide reference for clinical treatment. Materials and Methods 280 female patients with 486 benign breast lesions underwent minimally invasive excision using a ultrasonography-guided EnCor vacuumassisted device, occurrence and the influence factors of hematoma complicated from the operation was observed. Results All the 486 lesions were completely excised with EnCor system, hematoma( ≥ 1cm) were found in 47 cases after 24 hours and almost disappeared in 6 months. After analysis of the occurrence of hematoma, it was found that the following situations would lead to a higher incidence of hematoma, which included lumps ≥ 2.5 cm, more than two lesions removed at one time, lumps locating deep inside the areola or the edge of breasts, bigger and less dense breasts, operation in menstrual period, pressure bandaging after operation less than 12 hours and operation without using adrenaline(P〈0.05 or P〈0.01). Conclusion Benign lesions breast can be effectively excised using ultrasonography-guided EnCor vacuum device, and the factors listed below could affect the occurance of hematoma complicated from the surgery, including the size, location and number of the resected nodules, breast shape, surgery during menstrual period, postoperative pressure bandaging and the use of hemostatics.