乳腺良性肿块真空辅助切除术与传统区段切除术比较研究

发布时间：2018-04-03 13:58

本文选题：真空辅助旋切术　切入点：微创　出处：《浙江大学》2015年博士论文

【摘要】：研究背景随着时代的发展,科技的进步,越来越多的新颖技术应用于乳腺外科领域,其中就包括微创技术——乳腺肿块真空辅助旋切术。麦默通作为第一代真空辅助旋切系统,在处理乳腺良性肿块方面,有研究发现与传统区段切除术相比,在有效切除肿块前提下,麦默通在手术时长、手术切口长度方面均较传统区段切除具有优势,而在术后并发症方面,麦默通组较多,主要表现为出血、皮下淤血瘀斑形成。作为第二代的真空辅助切除系统安珂,在程序设置、操作流程方面等方面相比麦默通均有所优化,而系统比较安珂与传统区段切除术优劣性的临床研究仍较少。研究目的：比较应用安珂系统的微创手术与传统手术对于乳腺良性肿块治疗的差异,反映第二代真空辅助系统处理乳腺良性肿块的优缺点研究方法系统性回顾分析比较研究了浙医二院滨江院区肿瘤外科自2014.07至2015.03月的乳腺良性肿瘤2种术式的患者在肿瘤切除彻底性、手术美观性、手术时长及手术并发症方面的差异。研究结果在肿瘤切除的彻底性方面,2种术式并无明显差别(P0.05)；在手术时长及手术美观性方面,微创组要优于传统组；在手术并发症方面,术后疼痛控制,微创组要优于传统组,而在术后出血的风险上,传统组更优,在术中估计出血量和术后血肿瘀斑形成方面2组无明显差别。研究结论：微创手术在保证疗效的同时,在美观、手术时间控制及术后疼痛方面,均较传统区段切除占有优势,而在手术出血的风险控制方面,可能与传统手术相比,有一定的不足,但可以通过局麻药物加用肾上腺素和术后患者可忍受的加压包扎来弥补；微创手术是年轻的、对乳腺外观有一定追求的女性的优先选择。
[Abstract]:Research backgroundWith the development of the times and the progress of science and technology, more and more novel techniques have been applied in the field of breast surgery, including minimally invasive technique-vacuum assisted rotation of breast masses.As the first generation of vacuum assisted rotary cutting system, McMerton has found that compared with traditional segmental resection, it has been found that in the case of effective resection of the mass, the duration of the operation is longer.The length of incision was superior to that of traditional segmental resection, but in the postoperative complications, there were more complications in McMerton group, mainly in bleeding, subcutaneous congestion and ecchymosis.An Ke, the second generation vacuum assisted resection system, is better than McMerton in terms of program setting and operation flow, but there is still less clinical research on the advantages and disadvantages of traditional segmental resection.Objectives of the study:The difference between the minimally invasive surgery with An Ke system and the traditional operation in the treatment of benign breast masses was compared, reflecting the advantages and disadvantages of the second generation vacuum assistant system in the treatment of benign breast masses.Research methodA systematic review was conducted to study the differences between the two surgical methods of benign breast tumor from 2014.07 to March 2015.The difference in tumor resection, surgical beauty, length of operation time and surgical complications were analyzed and compared between the patients with benign breast neoplasms from 2014.07 to March 2015.The results were as follows: (1) the difference between the two types of surgical procedures for benign breast tumors in Binjiang Hospital of Zhejiang Medical second Hospital.Research resultsIn terms of the thoroughness of tumor resection, there was no significant difference between the two operative methods (P 0.05); the minimally invasive group was superior to the traditional group in terms of the length of the operation and the beauty of the operation; in terms of postoperative complications, the postoperative pain control was better in the minimally invasive group than in the traditional group.However, the risk of postoperative hemorrhage was better in the traditional group, and there was no significant difference between the two groups in the estimation of blood loss during operation and the formation of postoperative hematoma ecchymosis.The study concluded that:Minimally invasive surgery has advantages over traditional segmental resection in terms of beauty, operation time control and postoperative pain, while the risk control of surgical bleeding may have some shortcomings compared with traditional surgery.But it can be compensated by local anesthetic plus epinephrine and the pressure bandage that the patient can bear after operation; minimally invasive surgery is a young woman with a certain pursuit of breast appearance.
【学位授予单位】：浙江大学
【学位级别】：博士
【学位授予年份】：2015
【分类号】：R737.9

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