【摘要】 目的 探讨高频超声引导下乳腺钙化微创切除活检与开放切除活检的优缺点。方法回顾性分析161侧（154例患者，其中7例双侧）乳腺钙化患者的临床病理资料，根据手术方式的不同将患者分为微创切除活检组（93例97侧）和开放切除活检组（61例64侧）。微创切除活检组采用高频超声引导下真空辅助旋切活检术切除钙化灶，开放切除活检组采用传统开放切除的方法，所有切除标本送术中拍片检查和病理检查。比较两组目标钙化灶一次性活检成功率、活检切口大小、术后伤口感染率、住院时间、住院费用等。结果 活检切口大小微创活检组是0.31±0.03 cm，开放活检组是4.15±0.72 cm，两组差异有统计学意义（P<0.01）。目标钙化灶一次性活检成功率，微创活检组为96.91%，开放活检组为96.88%，差异无统计学意义（P>0.05）。术后伤口感染率两组均为0。病理结果为良性的患者中，微创活检组的住院时间为2.20±1.30天，开放活检组为5.80±1.97天，差异有统计学意义（P<0.05）。病理良性的患者中，微创活检组的住院费用为9303.87±4328.08元，开放活检组为12 614.5±4055.85元，差异有统计学意义（P<0.001）。结论 高频超声指引下对目标钙化灶进行微创切除活检与传统开放切除活检均是安全有效的活检方法，微创切除活检具有活检切口小、住院时间短、住院费用较低的优势。更多还原

【Abstract】 Objective To explore the advantages and disadvantages of high-frequency ultrasoundguided vacuum-assisted biopsy versus open surgical biopsy for breast calcifications. Methods A retrospective study analysis was conducted on the clinical and pathological data of 161 breast calcification cases(154 patients, including 7 cases of bilateral sides). Based on the surgical approach, patients were divided into two groups: the vacuum-assisted biopsy group(93 cases with 97 lesions) and the open surgical biopsy group(61 cases with 64 lesions). The vacuum-assisted group underwent vacuum-assisted stereotactic biopsy under high-frequency ultrasound guidance to remove the calcifications, while the open surgical biopsy group underwent traditional open surgical excisional biopsy. All specimens of the margins were subjected to intraoperative radiography and pathological examination. The two groups were compared in terms of success rate of single-attempt biopsy for target calcifications, incision size, postoperative infection rate, hospital stay, and hospitalization costs. Results The incision size in the vacuum-assisted biopsy group was 0.31±0.03 cm, while in the open surgical biopsy group, it was 4.15±0.72 cm, showing a statistically significant difference(P<0.01). The success rate of single-attempt biopsy for target calcifications was 96.91% in the vacuum-assisted group and 96.88% in the open surgical biopsy group, with no statistically significant difference(P>0.05). The postoperative infection rate was 0% in both groups.Among patients with benign pathology result, length of the hospital stay in the vacuum-assisted group was 2.20±1.30 days, compared to 5.80±1.97 days in the open surgical biopsy group, showing a statistically significant difference(P<0.05). The hospitalization costs for patients with benign pathology result were 9303.87±4328.08 CNY in the vacuum-assisted group and 12 614.5±4055.85 CNY in the open surgical biopsy group, with a statistically significant difference(P<0.001). Conclusion Both vacuum-assisted biopsy under high-frequency ultrasound guidance and traditional open surgical biopsy to remove target breast calcifications are safe and effective methods. Vacuum-assisted biopsy offers advantages of smaller incision size, shorter hospital stays, and lower hospitalization costs.更多还原