本文選題：真空輔助旋切術(shù)　切入點：微創(chuàng)　出處：《浙江大學(xué)》2015年博士論文

【摘要】：研究背景 隨著時代的發(fā)展,科技的進步,越來越多的新穎技術(shù)應(yīng)用于乳腺外科領(lǐng)域,其中就包括微創(chuàng)技術(shù)——乳腺腫塊真空輔助旋切術(shù)。麥默通作為第一代真空輔助旋切系統(tǒng),在處理乳腺良性腫塊方面,有研究發(fā)現(xiàn)與傳統(tǒng)區(qū)段切除術(shù)相比,在有效切除腫塊前提下,麥默通在手術(shù)時長、手術(shù)切口長度方面均較傳統(tǒng)區(qū)段切除具有優(yōu)勢,而在術(shù)后并發(fā)癥方面,麥默通組較多,主要表現(xiàn)為出血、皮下淤血瘀斑形成。作為第二代的真空輔助切除系統(tǒng)安珂,在程序設(shè)置、操作流程方面等方面相比麥默通均有所優(yōu)化,而系統(tǒng)比較安珂與傳統(tǒng)區(qū)段切除術(shù)優(yōu)劣性的臨床研究仍較少。 研究目的： 比較應(yīng)用安珂系統(tǒng)的微創(chuàng)手術(shù)與傳統(tǒng)手術(shù)對于乳腺良性腫塊治療的差異,反映第二代真空輔助系統(tǒng)處理乳腺良性腫塊的優(yōu)缺點 研究方法 系統(tǒng)性回顧分析比較研究了浙醫(yī)二院濱江院區(qū)腫瘤外科自2014.07至2015.03月的乳腺良性腫瘤2種術(shù)式的患者在腫瘤切除徹底性、手術(shù)美觀性、手術(shù)時長及手術(shù)并發(fā)癥方面的差異。 研究結(jié)果 在腫瘤切除的徹底性方面,2種術(shù)式并無明顯差別(P0.05)；在手術(shù)時長及手術(shù)美觀性方面,微創(chuàng)組要優(yōu)于傳統(tǒng)組；在手術(shù)并發(fā)癥方面,術(shù)后疼痛控制,微創(chuàng)組要優(yōu)于傳統(tǒng)組,而在術(shù)后出血的風(fēng)險上,傳統(tǒng)組更優(yōu),在術(shù)中估計出血量和術(shù)后血腫瘀斑形成方面2組無明顯差別。 研究結(jié)論： 微創(chuàng)手術(shù)在保證療效的同時,在美觀、手術(shù)時間控制及術(shù)后疼痛方面,均較傳統(tǒng)區(qū)段切除占有優(yōu)勢,而在手術(shù)出血的風(fēng)險控制方面,可能與傳統(tǒng)手術(shù)相比,有一定的不足,但可以通過局麻藥物加用腎上腺素和術(shù)后患者可忍受的加壓包扎來彌補；微創(chuàng)手術(shù)是年輕的、對乳腺外觀有一定追求的女性的優(yōu)先選擇。
[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.
【學(xué)位授予單位】：浙江大學(xué)
【學(xué)位級別】：博士
【學(xué)位授予年份】：2015
【分類號】：R737.9

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