Huo Hui-Ping, Wan Wen-Bo, Wang Zhi-Li, Li Hong-Fei, Li Jun-Lai
Department of South Building Ultrasound, Chinese People's Liberation Army General Hospital, Beijing 100853, China.
Department of South Building Ultrasound,Chinese People's Liberation Army General Hospital, Beijing 100853, China.
Chin Med Sci J. 2016 Mar 20;31(1):31-36. doi: 10.1016/s1001-9294(16)30019-0.
Objective To explore the influence factors in hematoma formation after removing benign breast lesions with an ultrasound-guided vacuum-assisted system.Methods A total of 232 females with 312 benign breast masses received excisional biopsy with ultrasound- guided vacuum-assisted system. The pathology of patients, Results of hematoma development and outcome, influence factors for hematoma occurrence (nodule size, nodule location, number of nodule, breast shape, menstrual period, efficacy time of bandage, and application of hemostatic agents during the procedure) were recorded.Results Pathologic examination revealed fibroadenomas in 138 lesions, fibroadenosis in 127 lesions, intraductal papillomas in 39 lesions, inflammatory change in 4 lesions, retention cyst of the breast in 3 lesions, and benign phyllodes tumor in 1 lesion. Thirty hematomas were observed in patients (9.6%). Finally, 97.0% hematomas were absorbed completely within 6 months follow-up. The incidence rates of hematoma were increased by 24.7%, 10.0%, 63.2%, 13.9% in the nodule diameter larger or equal to 25 mm group, removal of larger or equal to two nodules once time from one patient group, menstrual period group, and larger and loose breast group, respectively (all P<0.05). However, the incidences were decreased by 60.6% in the bandage performed for 12-24 hours or beyond 24 hours group (P<0.05). The multiple logistic regression models revealed that nodule size (χ=15.227, P<0.001), number of nodule (χ=7.767, P=0.005), menstrual period (χ=24.530, P<0.001), and breast shape (χ=9.559, P=0.002) were independent risk factors associated with hematoma occurrence, but efficacy time of bandage was a protective factor associated with hematoma occurrence.Conclusion The occurrence of hematoma after the minimally invasive operation was associated with nodule size, number of nodule, menstrual period, breast shape, and efficacy time of bandage.
目的 探讨超声引导下真空辅助系统切除乳腺良性病变后血肿形成的影响因素。方法 232例女性共312个乳腺良性肿块接受超声引导下真空辅助系统切除活检。记录患者的病理情况、血肿发生情况及转归、血肿发生的影响因素（结节大小、结节位置、结节数量、乳房形态、月经期、绷带包扎有效时间、术中止血剂的应用）。结果 病理检查显示，138个病灶为纤维腺瘤，127个病灶为乳腺腺病，39个病灶为导管内乳头状瘤，4个病灶为炎症改变，3个病灶为乳腺潴留性囊肿，1个病灶为良性叶状肿瘤。患者中观察到30例血肿（9.6%）。最后，97.0%的血肿在6个月随访内完全吸收。结节直径大于或等于25 mm组、一次切除大于或等于两个结节组、月经期组、乳房较大且松弛组的血肿发生率分别增加24.7%、10.0%、63.2%、13.9%（均P<0.05）。然而，绷带包扎12 - 24小时或超过24小时组的发生率降低了60.6%（P<0.05）。多因素logistic回归模型显示，结节大小（χ=15.227，P<0.001）、结节数量（χ=7.767，P=0.005）、月经期（χ=24.530，P<0.001）和乳房形态（χ=9.559，P=0.002）是与血肿发生相关的独立危险因素，而绷带包扎有效时间是与血肿发生相关的保护因素。结论 微创术后血肿的发生与结节大小、结节数量、月经期、乳房形态及绷带包扎有效时间有关。
