目的 评价一种新型低温等离子手术系统(NTS-100)对猪皮肤切割愈合的影响.方法 选择6头巴马小型猪的背部脊柱两侧皮肤,获取愈合时间分别为1、2、3和6周的皮肤标本,比较手术刀、新型低温等离子手术系统(NTS-100)、高频电刀、低温等离子手术刀(Pulsed-Electron Avalanche Knife,PEAK)对皮肤切口愈合的影响,评价指标包括出血量、疤痕宽度、炎性细胞浸润程度和疤痕拉力强度等.结果 新型低温等离子手术系统(NTS-100)止血效果优于手术刀(P<0.01),各时间点的疤痕宽度均小于高频电刀(P<0.05),愈合时间为3周和6周时的T淋巴细胞和巨噬细胞浸润显著少于高频电刀(P<0.01),愈合时间为3周时的瘢痕拉力强度高于高频电刀(P<0.05),各评价指标与PEAK比较,无统计学差异(P>0.05).结论 新型低温等离子手术系统(NTS-100)减少术后伤口瘢痕形成,提高伤口愈合强度,具有可靠的安全性,可以满足微创精细手术的要求.

Background: Intraductal papillomas are discrete benign tumors of the breast duct epithelium. Due to the risk of subsequent carcinoma, a surgical excision is generally recommended as a precaution. However, it is difficult to initially diagnose and accurately locate the lesions both in pre-surgery and surgery periods. Methods: Retrospectively analyzed 245 patients, with a pathologically proven breast intraductal papillomas. All the patients underwent magnetic resonance imaging (MRI) scans and ultrasound examination(s) presurgery and/or in surgery. All the patients who underwent surgery were divided into four groups according to the following operation method type(s): ultrasound & clinical examination excision, methylene blue notation excision, methylene blue notation & MRI guide excision, and MRI guide excision. Then, the differences between the last two MRI guide excisions and the first two conventional methods were analyzed. Afterwards, 238 patients were followed up for recurrence checks. SPSS 19.0 statistical software was used and the results of P<0.05 being considered statistically significant. Results: A total of 161 (65.7%) and 48 (19.6%) patients were pathological diagnosed of solitary and multiple papilloma separately, and 36 (14.7%) patients had papillomatosis; 168 and 243 cases with positive signs, which were detected in all 245 patients who had underwent ultrasound and MRI examination(s), with the detection rate being 68.6% and 99.0% respectively. MRI imaging could clearly present mass-like lesions (solitary and multiple mass) and non-mass like lesions (ductal and regional). Whereas, ultrasound imaging could barely show mass-like (solitary and multiple mass) lesions. In surgery, when compared with traditional methods, MRI imaging could also more accurately locate the lesions and guide the excision. MRI guidance is both applicable to patients with and without nipple discharge, in addition to those who show no abnormal signs in ultrasound imaging. The recurrence-free survival time with traditional surgery methods was significantly lower than those in the MRI guide groups. Conclusions: MRI is accurate at the detection, localization and resection range of intraductal papilloma lesions; all capabilities which are critical to successful breast surgery.