99例术前干预非哺乳期乳腺炎的临床分析
| 作者: |
1刘鑫,
2贾红燕,
2王斌,
1郝冉,
1张傲雪,
1张佳琪
1 山西医科大学第一临床医学院，太原 030000 2 山西医科大学第一医院普外科，太原 030000 |
| 通讯: |
贾红燕
Email: swallowjhy@sina.com |
| DOI: | 10.3978/j.issn.2095-6959.2021.02.003 |
| 基金: | 山西省自然科学基金(201901D111347)。 |
摘要
目的：区分非哺乳期乳腺炎中两种常见的病理类型，探讨术前干预对非哺乳期乳腺炎的治疗效果。方法：收集非哺乳期乳腺炎患者99例，分析其临床资料并观察术前干预及术后疗效。结果：在99例患者中，有66例导管周围乳腺炎(periductal mastitis，PDM)，33例肉芽肿乳腺炎(granulomatous mastitis，GM)。PDM组中病灶全部位于乳晕2 cm以外22例，位于乳晕2 cm以内44例，GM组中23例位于乳晕2 cm以外，10例位于乳晕2 cm以内，两组相比差异具有统计学意义(P<0.05)。所有患者在初次就诊随机给予50%硫酸镁或如意黄金散外敷治疗，经干预治疗后2例(2.02%)患者得到治愈，28例(28.28%)患者显效，53例(53.54%)患者有效，16例(16.16%)患者治疗无效病情进展，治疗总有效率83.84%。PDM组中59例(89.39%)有效，7例无效，GM组中24例(72.72%)有效，9例无效，两组相比差异具有统计学意义(P<0.05)。在56例50%硫酸镁和43例如意黄金散治疗的对比中，两组疗效对比差异无统计学意义(P>0.05)。在硫酸镁组中，PDM患者39例有效，3例无效；GM患者8例有效，6例无效，两组疗效对比差异具有统计学意义(P<0.05)。未治愈的患者经手术治疗，随访发现20例(20.20%)患者术后出现同侧或对侧复发或术后感染积液。结论：50%硫酸镁或如意黄金散外敷治疗非哺乳期乳腺炎有效且效果类似，且50%硫酸镁对导管周围乳腺炎更有效，术前干预治疗非哺乳期乳腺炎缩小手术范围，可以提高患者对美观的要求，为临床提供重要参考。
关键词：
非哺乳期乳腺炎；术前干预；疗效
Clinical analysis of 99 cases of intervention in non-puerperal mastitis before surgery
CorrespondingAuthor: JIA Hongyan Email: swallowjhy@sina.com
DOI: 10.3978/j.issn.2095-6959.2021.02.003
Foundation: This work was supported by the Shanxi Provincial Natural Science Foundation, China (201901D111347).
Abstract
Objective: To distinguish two common pathological types of non-puerperal mastitis and to explore the therapeutic effect of preoperative intervention on non-puerperal mastitis. Methods: 99 patients with non-puerperal mastitis were collected, their clinical data were analyzed, and the preoperative intervention and postoperative curative effect were observed. Results: Among 99 patients, there were 66 cases of periductal mastitis (PDM) and 33 cases of granulomatous mastitis (GM). In PDM group, all the lesions were located outside the areola 2cm in 22 cases and within the areola 2cm in 44 cases. In GM group, 23 cases were located outside the areola 2 cm and 10 cases within the areola 2 cm. There was significant difference between the two groups (P<0.05). All patients were randomly given external application of 50% magnesium sulfate or Ruyi Gold Powder at the first visit. After intervention treatment, the total effective rate was 83.84%: 2 patients (2.02%) were cured; 28 cases (28.28%) were significantly effective; 53 cases (53.54%) were effective; 16 cases (16.16%) were ineffective. In the PDM group, 59 cases (89.39%) were effective and 7 were ineffective, while in the GM group, 24 cases (72.72%) were effective and 9 were ineffective. The difference between the two groups was statistically significant (P<0.05). In the comparison of 56 cases of 50% magnesium sulfate and 43 cases of Ruyi gold powder, there was no significant difference between the two groups (P>0.05). In magnesium sulfate group, statistically significant difference (P<0.05) of the treatment effect was noticed between the PDM and GM patients: 39 cases with PDM were effective and 3 were ineffective, while 8 cases with GM were effective and 6 were ineffective. The uncured patients were treated by operation, and 20 cases (20.20%) were found to have ipsilateral or contralateral recurrence or postoperative infection. Conclusion: 50% magnesium sulfate or Ruyi gold powder is with similar therapeutic effect in the treatment of non-puerperal mastitis, though 50% magnesium sulfate is more effective in periductal mastitis. Preoperative intervention in the treatment of non-puerperal mastitis can reduce the scope of operation, which can facilitate the aesthetic requirements of patients and provide important reference for clinical practice.
Keywords：
non-puerperal mastitis; preoperative intervention; effective