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目的评价术中超声在早期触诊阴性乳腺癌保乳手术的应用。方法回顾性分析2015年1月至2016年7月郑州大学附属肿瘤医院收治的98例早期触诊阴性的乳腺癌患者,患者分为术中超声组和术前放置定位针组,观察两组保乳手术冰冻活检切缘阳性率,肿瘤病灶距切缘平均距离及平均手术时间。结果术前放置定位针组切缘阳性率为16.7%,术中超声组切缘阳性率为12.0%,术中超声组切缘阳性率低于术前放置定位组,但两者差异无统计学意义(P>0.05),术前放置定位针组肿瘤病灶距切缘平均距离为(1.6±0.15)cm,术中超声组肿瘤病灶距切缘平均距离为(1.3±0.27)cm,术中超声组距切缘平均距离小于术前放置定位针组,两者差异有统计学意义(P<0.05),术前放置定位针组平均手术时间为(25.32±1.76)min,术中超声组平均手术时间为(18.14±1.24)min,两者差异有统计学意义(P<0.05)。结论保乳手术中术中超声的应用较术前放置定位针能减少手术时间,减少病灶周围正常腺体组织切除范围,增强保乳手术的美容效果,值得在临床中推广。
Objective To evaluate the application of intraoperative ultrasound in the early palpation of negative breast cancer breast conserving surgery. Methods A retrospective analysis of 98 patients with early palpation-negative breast cancer admitted to Cancer Hospital of Zhengzhou University from January 2015 to July 2016 was performed. The patients were divided into intraoperative ultrasound group and preoperative positioning needle group. Frozen biopsy positive margins of breast surgery, tumor lesions from the average distance from the edge and the average operation time. Results The positive rate of the margins of the preoperative positioning needle group was 16.7%. The positive rate of the surgical margins in the ultrasound group was 12.0%. The positive rate of the margins of the ultrasound group during operation was lower than that of the preoperative localization group, but there was no significant difference between the two groups (P> 0.05). The average distance from tumor location to the edge of the tumor was (1.6 ± 0.15) cm before surgery, and the average distance from the tumor to the tumor in the ultrasound group was (1.3 ± 0.27) cm. The intraoperative ultrasonography The average distance between the group and the margin was less than that of the preoperative positioning needle group, the difference was statistically significant (P <0.05). The mean operative time of the preoperative positioning needle group was (25.32 ± 1.76) min. The intraoperative ultrasound group average operation Time was (18.14 ± 1.24) min, the difference was statistically significant (P <0.05). Conclusion The application of intraoperative ultrasound during breast-conserving surgery compared with preoperative placement of positioning needles can reduce the operation time, reduce the scope of excision of normal gland tissue around the lesion and enhance the cosmetic effect of breast-conserving surgery. It is worth to be popularized clinically.