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超声引导下微波消融术与传统手术治疗浆细胞性乳腺炎的对比研究:一项多中心研究

Comparative study of ultrasound-guided microwave ablation and traditional surgery in the treatment of plasma cell mastitis: a multicenter study.

作者信息

Zhou Ying, Xu Zhi-Feng, Xing Wei, Liu Yuan, Xu Zhao, Tan Guo-Liang, Wang Shu-Rong, Xu Dong

机构信息

Department of Surgery, Hebei Provincial Hospital of Traditional Chinese Medicine, Shijiazhuang, China.

Department of Ultrasound Medicine, Yantai Affiliated Hospital of Binzhou Medical College, Yantai, China.

出版信息

Quant Imaging Med Surg. 2023 Mar 1;13(3):1838-1848. doi: 10.21037/qims-21-1132. Epub 2022 Dec 6.

Abstract

BACKGROUND

Plasma cell mastitis (PCM) is a benign breast disease that is refractory and difficult to cure. We integrated microwave ablation into the treatment of PCM to compare the clinical value of ultrasound-guided microwave ablation and traditional surgery in the treatment of PCM.

METHODS

A total of 68 patients with PCM who were admitted to 3 centers (Zhejiang Cancer Hospital, Hebei Province Hospital of Traditional Chinese Medicine, and Yantai Affiliated Hospital of Binzhou Medical university) from January 2017 to June 2019 were selected. All patients were diagnosed with PCM after pathological and clinical manifestations. Among these, 38 cases were treated with ultrasound-guided microwave ablation, and 30 cases were treated with traditional surgery. The operation time, hospitalization time, incision healing, intraoperative blood loss, postoperative pain degree, evaluation of breast shape effect, time taken for postoperative lesion disappearance, effective rate, and recurrence were recorded in the follow-up, and the clinical efficacy was compared and observed.

RESULTS

The effective rate of the ablation group was 86.8% (33/38), that of the operation group was 46.7% (14/30), and the difference was statistically significant (95% CI: 2.311-24.618; P<0.05). The average time of the lesion completely disappearing was 75.55±43.59 days in the ablation group and 103.87±45.98 days in the operation group, and the difference was statistically significant (P<0.05). The hospital stays, operation time, and intraoperative blood loss of patients in the ablation group were less than those of the operation group, and the difference was statistically significant (95% CI: -10.69 to -6.27, 95% CI: -77.06 to -51.26, and 95% CI: -21.54 to -13.64; P<0.05). The postoperative pain scoring, operative incision healing at 14 days after the operation, and breast appearance evaluation after treatment in the ablation group were better than those of the operation group, and the difference was statistically significant (P<0.05).

CONCLUSIONS

Compared with traditional surgery, ultrasound-guided microwave ablation is a more effective treatment option for PCM.

摘要

背景

浆细胞性乳腺炎(PCM)是一种难治且难以治愈的良性乳腺疾病。我们将微波消融纳入PCM的治疗中,以比较超声引导下微波消融与传统手术治疗PCM的临床价值。

方法

选取2017年1月至2019年6月在3个中心(浙江省肿瘤医院、河北省中医院、滨州医学院烟台附属医院)收治的68例PCM患者。所有患者经病理及临床表现确诊为PCM。其中,38例采用超声引导下微波消融治疗,30例采用传统手术治疗。随访记录手术时间、住院时间、切口愈合情况、术中出血量、术后疼痛程度、乳房外形效果评价、术后病灶消失时间、有效率及复发情况,并比较观察临床疗效。

结果

消融组有效率为86.8%(33/38),手术组有效率为46.7%(14/30),差异有统计学意义(95%CI:2.311 - 24.618;P<0.05)。消融组病灶完全消失的平均时间为75.55±43.59天,手术组为103.87±45.98天,差异有统计学意义(P<0.05)。消融组患者的住院时间、手术时间及术中出血量均少于手术组,差异有统计学意义(95%CI:-10.69至-6.27,95%CI:-77.06至-51.26,95%CI:-21.54至-13.64;P<0.05)。消融组术后疼痛评分、术后14天手术切口愈合情况及治疗后乳房外观评价均优于手术组,差异有统计学意义(P<0.05)。

结论

与传统手术相比,超声引导下微波消融是治疗PCM更有效的选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3421/10006106/0293ee9fafe7/qims-13-03-1838-f1.jpg

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