【Abstract】Objective To evaluate the application of duct endoscopy in the diagnosis of breast diseases characterized by nipple discharge. Methods One hundred and sixtynine consecutive cases from October 2003 to September 2004 who had duct endoscopy for nipple discharge were reviewed and followed up. Results Of 169 cases, 79 ductitis, 62 intraductal papilloma, 9 intraductal carcinoma in situ, 19 without breast diseases were diagnosed under duct endoscopy. During following up, the diagnostic accuracy of intraductal papilloma and intraductal carcinoma in situ with duct endoscopy was 89.8%(44/49) and 55.6%(5/9),respectively. There was only one patient who had breast pain and mild skin redness which was cured with oral antibiotics for 3 days. Conclusion Duct endoscopy is an only technique to explore the etiology for duct discharge under vision. It is direct, safe and effective, with a high accuracy.
【摘要】目的探讨超声导向下Mammotome活检及旋切系统切除乳腺肿块的并发症及其处理。方法在超声导向下，利用Mammotome系统对乳腺肿块进行活检和切除，对出现的并发症进行及时的处理。结果46例患者的75个乳腺肿块被切除，病理证实68个为纤维腺瘤，7个为纤维腺病。术中并发症包括出血、血肿和胸大肌损伤，经及时处理后恢复，术后并发症为瘢痕形成。结论Mammotome乳腺肿块切除术具有创伤小、并发症少的优点，是一种有效的、不影响乳房外观的微创手术，超声监控能够减少和发现并发症并进行正确的处理。
ObjectiveTo explore the feasibility strategy for patients’ fast track after the operation of thyroid papillary carcinoma with no drainage tube application.MethodsPatients undergone the operation of thyroid papillary carcinoma from June 2017 to March 2018 were enrolled in this retrospective study. All patients were from the same medical teams composed with the same attending doctors. They were divided into two groups according to the drainage tube applied or not. Finally the incidence of postoperative hematoma, incisional infection, and subcutaneous effusion were compared between the two groups, while the length of stay, pain score after operation, and satisfaction of patients were also analyzed.ResultsThe incidences of postoperative hematoma, incisional infection, and subcutaneous effusion were totally similar between the two groups. While the length of stay and pain score were significantly shorter or lower, satisfaction of patients were higher in group of no drainage tube applied (P<0.05).ConclusionsThe operation of total thyroidectomy plus bilateral central lymph node dissection for papillary thyroid cancer without drainage tube will not increase the probability of complications such as hematoma, incisional infection and subcutaneous effusion. On the contrary, it can shorten hospitalization time, reduce wound pain and improve patient satisfaction in the concept of rapid rehabilitation.
Objective To observe the effectiveness of IMPACT management mode on self-care and management abilities of breast cancer patients undergoing chemotherapy with implantable venous access port (VAP). Methods Breast cancer patients who underwent chemotherapy with VAP at Shangjin Hospital, West China Hospital, Sichuan University between March 2020 and June 2021 were prospectively included. IMPACT mode was used for self-management training guidance. The patient self-care abilities before training and at 1 month, 2 months, and 3 months of training were compared, and the patient self-management abilities at 1 month and 3 months of training were compared. Results A total of 74 patients with breast cancer undergoing chemotherapy with VAP were included. The total score of self-care ability of patients before training and at 1 month, 2 months, and 3 months of training was 112.11±14.63, 123.20±15.73, 127.95±13.89, and 131.92±13.60, respectively, and all the between-time-point differences were statistically significant (P<0.05). In terms of self-concept score, all the between-time-point differences were statistically significant (P<0.05) with increasing score over time, except the difference between the score at 3 months of training and that at 2 months of training (P>0.05). In terms of self-responsibility and self-care skill scores, all the between-time-point differences were statistically significant (P<0.05) with increasing scores over time, except the difference between the score at 2 months of training and that at 1 month of training (P>0.05). In terms of health knowledge level, the scores at 1 month, 2 months, and 3 months of training were higher than that before training (P<0.05), and the score at 3 months of training was higher than that at 1 month of training (P<0.05). The self-management ability scores in all dimensions at 3 months of training were higher than those at 1 month of training, and the differences were statistically significant (P<0.05). Conclusion The IMPACT management mode can effectively improve the self-care and management abilities of breast cancer patients undergoing chemotherapy with VAP, thereby ensuring the normal use of VAP, reducing the occurrence of complications, and reducing the burden on families and society.
目的 探讨和对比无针缝合器与传统的二期针线缝合和蝶形胶布拉拢对感染切口的闭合疗效。方法 对49例肝胆术后切口感染患者，待感染切口引流物明显减少、创面有健康肉芽生长时，应用立辰无针缝合器逐步闭合切口。另81例肝胆术后切口感染患者分别采用蝶形胶布拉拢或二期传统针线缝合，对比3组患者切口自换药开始至切口拆线的愈合时间。结果 无针缝合治疗组的愈合时间为（23.0±6.5）d，明显短于蝶形胶布拉拢组的（31.0±10.4）d和二期传统针线缝合组的（34.0±14.1）d（P＜0.05）。蝶形胶布拉拢组与二期传统针线缝合组愈合时间差异无统计学意义（P＞0.05）。结论 采用无针缝合器治疗感染切口可在引流换药的同时逐步闭合切口，促进其早期愈合。
ObjectiveTo evaluate the safty of recurrent laryngeal nerve (RLN) and parathyroid if Pseudomonas aeruginosa injection (PAI) is used after total thyroidectomy and central neck dissection (CND).MethodsFrom Mar. 2016 to Oct. 2017, we recruited 113 patients with papillary thyroid cancer (PTC) who accepted total thyroidectomy and CND. During operation, 1 mL of PAI was applied in 58 patients (local spray group) and 55 not (control group). The hoarseness, hypoparathyroidism, chylous fistula, drainage volume, hospital stay, and incidence of complications were compared between the two groups.ResultsThe two groups embraced few difference in age, gender, BMI, tumor site, the diameter of tumor and the number of metastatic and the harvested lymph nodes (P>0.05). There were nobody who has suffered in hoarseness and permanent hypoparathyroidism in both groups at any time after operation. There was no significant differences of complication between the two groups. The drainage volume at 24 h after operation in the local spraying group was more than that in the control group, and the difference was statistically significant (P=0.023). There were 2 patients had chylous fistula after surgery in the control group but none in the local spray group. The total volumes of drainage, incidence of fever and incision infection, the mean stay in the hospital, and the postoperative pain score had no statistic significance in the both groups.ConclusionAfter total thyroidectomy and CND, local spraying of PAI in the wound cavity is safe and will not damage the recurrent laryngeal nerve.