真空辅助乳腺旋切术与常规开放切除术治疗乳腺良性肿物的围手术期指标对比研究

Comparative study on perioperative outcomes of vacuum-assisted breast biopsy versus conventional open excision for benign breast tumors

摘要:

目的 探讨真空辅助乳腺旋切术（VABB）与常规开放切除术治疗乳腺良性肿物的围手术期临床效果差异。方法 回顾性分析2022年1月—2025年1月马鞍山市人民医院收治的222例乳腺良性肿物患者作为研究对象，根据不同手术方法将患者分为观察组（122例，VABB治疗）和对照组（100例，开放切除术）。比较两组患者围手术期指标、创口及恢复情况、美容效果指标、炎症应激指标、疼痛情况和术后并发症发生情况。结果 观察组手术时间短于对照组（P <0.05），术中出血量少于对照组（P <0.05）。观察组的切口长度、切口愈合时间、术后住院时间均短于对照组（P <0.05）。两组患者肿瘤残留率比较，差异无统计学意义（P >0.05）。观察组的血管分布、色素沉着、厚度及柔软度评分均低于对照组（P <0.05）。观察组术后降钙素原（PCT）、C反应蛋白（CRP）、中性粒细胞弹性蛋白酶（NE）和皮质醇（Cor）水平均低于对照组（P <0.05）。观察组手术前后PCT、CRP、NE、Cor的差值均小于对照组（P <0.05）。观察组与对照组术后1、3、5 d静息状态下疼痛数字评分法（NRS）评分比较，结果 ①不同时间点NRS评分比较，差异有统计学意义（P <0.05）；②两组患者NRS评分比较，差异有统计学意义（P <0.05），观察组NRS评分较低，相对镇痛效果较好；③两组患者NRS评分变化趋势比较，差异有统计学意义（P <0.05）。观察组术后并发症总发生率低于对照组（P <0.05）。结论 VABB在保证肿瘤切除效果的同时，具有创伤小、恢复快、美容效果佳等优势，是治疗乳腺良性肿物的优选微创术式。

Abstract:

Objective To compare the perioperative clinical outcomes of vacuum-assisted breast biopsy (VABB) and conventional open excision for benign breast tumors.Methods A retrospective analysis was conducted on 222 patients with benign breast tumors treated at Ma'anshan People's Hospital from January 2022 to January 2025. Based on surgical approach, patients were divided into an observation group (n = 122, VABB) and a control group (n = 100, open excision). Perioperative parameters, wound characteristics, recovery outcomes, cosmetic results, inflammatory stress markers, pain levels, and postoperative complications were compared between the two groups.Results The observation group had a shorter operative duration and less intraoperative blood loss than the control group (P < 0.05). Incision length, wound healing time, and postoperative length of hospital stay were all shorter in the observation group (P < 0.05). No significant difference was found in the rate of residual tumor between the two groups (P >0.05). The scores for vascular distribution, pigmentation, thickness, and softness were all lower in the observation group (P < 0.05). Postoperative PCT, CRP, NE, and Cor levels were lower in the observation group compared with the control group (P < 0.05), and their differences before and after surgery were also smaller in the observation group (P < 0 .05). The NRS scores at postoperative days 1, 3, and 5 under resting conditions were compared between the two groups using repeated-measures analysis of variance. The results demonstrated that NRS scores differed significantly across different time points (P < 0.05), and that there was a significant difference in NRS scores between the two groups (P < 0.05), with the observation group showing lower scores and better analgesic effects. The change trends of NRS scores over time also differed significantly between the two groups (P < 0.05). The incidence of postoperative complications was lower in the observation group (P < 0.05).Conclusion VABB provides comparable tumor resection efficacy while offering the advantages of minimal trauma, faster recovery, better cosmetic results, and fewer complications. It represents an optimal minimally invasive surgical option for patients with benign breast tumors.