非哺乳期复发性乳腺炎的诊断和治疗探讨（附68例分析）  

NON-LACTATIVE RECURRING MASTITIS (68 CASES ANALYSIS)

作　　者：李玉珠[1] 姚其远[1] 金忱[1] 朱锡琪[1] 

机构地区：[1]上海医科大学附属华山医院,上海医科大学

出　　处：《上海医学》1994年第10期569-571,共3页Shanghai Medical Journal

摘　　要：非哺乳期复发性乳腺炎临床表现可分为三种类型：急性乳房脓肿、乳房肿块和慢性瘘管。Ｂ超、细针穿刺细胞学检查和病理检查最具诊断价值。作者认为对乳房脓肿作单纯切开引流常致复发及瘘管形成。有复发者应争取于静止期将所有病变组织及导管广泛切除。表现为炎性肿块者，单用药物治疗常导致复发。只要炎症局限良好，即使有中央脓肿形成，仍应作肿块及周围病变组织和导管切除术。慢性瘘管者，可作瘘管切开、扩大引流，或搔刮术。若能同时切除周围的炎症肉芽和扩张的导管，效果更好。久治不愈的瘘管、严重变形的乳房，才考虑作单纯乳房切除术。部分年轻患者可同期或分期行乳房整形术。on-lactative and recurring mastitis is not uncommon.According to the clinicalpictures,it can be categorized into three types :acute mastitis or abscess formation,breast lump and chronic fistula.The pathogenesis is unknown,but the mammary duct ectasia,congenital invertednipple and injuries of breast may be emphasized.B-ultrasonography,fine neelde aspi-ration biopsy and pathologic examination may be helpful to the diagnosis.For acute mammary abscesses,simple incision and drainage of the abscess or anti-biotics treatment may lead to recurrence or fistula formation,If the abscess recurred,thetreatment of choice is to excise the affected duct and granulomatous tissue surroundingit during quiescent stage.For breast lump types,even if the abscess formation,the rather well circumscribedlump and its surrounding inflammatory tissue excision is a good remedy.If the dilatedduct within the nipple and subareolar area is detected,on operation,it must be excised.Chronic fistula sometimes communicates with the lactiferous duct,the key to a su-ccessful treatment of this disease is to excise the fistula and affected duct,along withinflammatory tissue surrounding it.The incisinal wound can be closed primarily,thescar can be left open to heal by second intension.The accurate treatment will producelather good cosmetic results to the breas.Simple mastectomy is only indicated in pa-tients with untreatable complicative fistulas and severe abnormality of the breast.Breastreconstruction may be consideraded in younger women.

关 键 词：乳腺炎 乳房肿块 瘘管 乳房炎 诊断 治疗 

分 类 号：R655.8[医药卫生—外科学]