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中华医学超声杂志(电子版) ›› 2017, Vol. 14 ›› Issue (09) : 711 -715. doi: 10.3877/cma.j.issn.1672-6448.2017.09.016

所属专题: 乳腺超声 文献

介入超声影像学

超声引导下乳腺良性肿块旋切治疗术后血肿形成因素分析
姚春1,(), 李明奎2, 徐栋3, 陈维萍2, 茹融融2, 彭成忠1   
  1. 1. 310007 杭州市中医院超声科
    2. 311202 杭州,浙江萧山医院超声科
    3. 310022 杭州,浙江省肿瘤医院超声科
  • 收稿日期:2017-01-18 出版日期:2017-09-01
  • 通信作者: 姚春

Analysis of postoperative hematoma formation factors after ultrasound-guided minimally invasive surgery for benign breast masses

Chun Yao1,(), Mingkui Li2, Dong Xu3, Weiping Chen2, Rongrong Ru2, Chengzhong Peng1   

  1. 1. Department of Ultrasound, Hangzhou Hospital of Traditional Chinese Medicine, Hangzhou 310007, China
    2. Department of Ultrasound, Zhejiang Xiaoshan Hospital, Hangzhou 311202, China
    3. Department of Ultrasound, Zhejiang Cancer Hospital, Hangzhou 310022, China
  • Received:2017-01-18 Published:2017-09-01
  • Corresponding author: Chun Yao
  • About author:
    Corresponding author: Yao Chun, Email:
引用本文:

姚春, 李明奎, 徐栋, 陈维萍, 茹融融, 彭成忠. 超声引导下乳腺良性肿块旋切治疗术后血肿形成因素分析[J/OL]. 中华医学超声杂志(电子版), 2017, 14(09): 711-715.

Chun Yao, Mingkui Li, Dong Xu, Weiping Chen, Rongrong Ru, Chengzhong Peng. Analysis of postoperative hematoma formation factors after ultrasound-guided minimally invasive surgery for benign breast masses[J/OL]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2017, 14(09): 711-715.

目的

分析超声引导下乳腺肿块旋切术后血肿形成影响因素。

方法

回顾性分析2011年1月至2015年12月在萧山医院行超声引导下乳腺肿块旋切术的412例患者共516个肿块。采用χ2检验进行超声引导下乳腺肿块旋切术后血肿形成风险因素的单因素分析。采用Logistic回归分析进行超声引导下乳腺肿块旋切术后血肿形成风险因素的多因素分析。

结果

术后1周复查,肿块切除完全,有43个肿块切除后形成了长径≥1.0 cm的血肿;术后6个月所有血肿均完全吸收。不同粗细旋切针,不同切割针数,肿块不同大小、血流分级、深度、切除个数及不同术后绷带有效压迫时间的血肿发生率差异均有统计学意义(χ2=16.917、14.548、39.971、23.333、29.137、36.819、39.864,P均<0.001)。旋切针粗细、切割针数、肿块大小、深度、切除个数及术后绷带有效压迫时间是乳腺肿块旋切术后血肿形成多因素风险因素。

结论

旋切针粗细、切割针数、肿块大小、深度、切除多个肿块、术后绷带有效压迫时间是超声引导下乳腺良性肿块旋切术后血肿形成的危险因素,可通过筛选纳入手术的患者和采取针对性的措施提前预防血肿的发生。

Objective

To analyze the influencing factors of hematoma complicated from ultrasound-guided minimally invasive surgery for benign breast masses.

Methods

Retrospective analysis was performed in 412 patients with a total of 516 masses underwent the ultrasound-guided minimally invasive surgery for benign breast masses from January 2011 to December 2015 in Xiaoshan Hospital. The χ2 test was used to univariately analyze risk factors of hematoma formation after ultrasound-guided minimally invasive surgery for benign breast masses. Logistic regression analysis was used to multivariately analyze risk factors of hematoma formation.

Results

All masses were resected completely, however, hematomas with long diameter ≥1.0 cm were formed in 43 masses one week after surgery, and all hematomas were completely absorbed after six months. There were significant differences in the incidence of hematoma between the groups of different needle sizes, numbers of needle cutting, masses sizes, blood flow grades, depth, resection numbers and effective compression time of postoperative bandages (χ2=16.917, 14.548, 39.971, 23.333, 29.137, 36.819 and 39.864, respectively, all P<0.001). The needle sizes, the numbers of needle cutting, the masses sizes, blood flow grades, depth, resection numbers and the effective compression time constituted the risk factors of hematoma formation after the minimally invasive surgery.

Conclusions

The risk factors of the hematoma formation after ultrasound-guided minimally invasive surgery for benign breast masses included the different size of the needle, the number of different cutting needles, different size of the masses, the grade of blood flow, the number of resection and the different effective compression time of postoperative bandages. We could prevent the occurrence of hematoma in advance by screening patients and take corresponding measures.

图1 超声引导下乳腺肿块旋切术后血肿超声声像图。术后手术区域见大小为2.6 cm×1.7 cm、边界清晰、外形规则的液性无回声区,并可见血肿内部部分机化形成的絮状偏高回声
表1 超声引导下乳腺肿块旋切术后血肿形成风险因素单因素分析结果[%(例)]
表2 超声引导下乳腺肿块旋切术后血肿形成风险因素与赋值
表3 超声引导下乳腺肿块旋切术后血肿形成风险因素Logistic回归分析结果
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