哺乳期乳腺脓肿患者经超声引导下细针穿刺冲洗术后回乳的影响因素分析  

Factors influencing delactation in lactational breast abscess patients treated by ultrasound-guided aspiration and irrigation

作　　者：何湘萍[1] 陈颖[1] 马祥君[1] 丁松涛[1] 高海凤[1] 高雅军[1] 李艳[1] 张轶[1] He Xiangping;Chen Ying;Ma Xiangjun;Ding Songtao;Gao Haifeng;Gao Yajun;Li Yan;Zhang Yi(Center for Prevention and Treatment of Breast Diseases,Maternal and Child Health Hospital of Haidian District,Beijing 100080,China)

机构地区：[1]北京市海淀区妇幼保健院乳腺病防治中心

出　　处：《中华乳腺病杂志（电子版）》2019年第5期286-289,共4页Chinese Journal of Breast Disease(Electronic Edition)

摘　　要：目的探讨采用超声引导下细针穿刺冲洗术治疗乳腺脓肿的效果,分析影响治疗后患者回乳的相关因素。方法回顾性分析2016年1~12月北京市海淀区妇幼保健院乳腺病防治中心应用超声引导下细针穿刺冲洗术治疗的799例哺乳期乳腺脓肿患者的临床资料。从患者穿刺次数、产后时间、是否使用抗生素和脓肿位置等方面,采用χ2检验进行单因素分析,采用非条件Logistic回归模型分析各因素与回乳的关系。结果799例患者中有753例通过超声引导下细针穿刺冲洗术治愈,治愈率为94.2%(753/799)。治疗后回乳的患者有75例,回乳率为9.4%(75/799)。单因素分析显示,回乳与产后时间,抗生素的使用,穿刺次数和脓肿位置有关(χ^2=7.159、7.794、39.394、21.243,P=0.007、0.005和P<0.001)。Logistic回归分析显示,穿刺次数(OR=6.442,95%CI:1.851~22.420,P=0.003,)和中央区脓肿(OR=2.643,95%CI:1.480~4.721,P=0.001)是导致回乳的危险因素,而产后时间长是回乳的保护因素(OR=0.540,95%CI:0.315~0.927,P=0.025)。结论超声引导下细针穿刺冲洗术治疗哺乳期乳腺脓肿的治愈率高,回乳率低,具有良好的临床应用价值。产后42 d内发病、穿刺次数多和中央区脓肿更容易导致患者回乳。Objective To discuss the efficacy of ultrasound-guided aspiration and irrigation in lactational breast abscess patients and analyze the related factors of delactation.Methods The clinical data of 799 patients with lactational breast abscess treated by ultrasound-guided aspiration and irrigation in the Center for Prevention and Treatment of Breast Diseases,Maternal and Child Health Hospital of Haidian District from January to December 2016 were retrospectively analyzed.χ^2 test was used to analyze the data such as puncture frequency,postpartum time,antibiotics use and location of abscess.The unconditional logistic regression model was used to analyze the relationship between various factors and delactation.Results All 799 cases were followed up and 753 cases were cured.The cure rate was 94.2%(753/799).Delactation occurred in 75 cases and the delectation rate was 9.4%(75/799).Single-factor analysis showed that postnatal time,use of antibiotics,number of puncture and location of abscess were associated with delactation(χ^2=7.159,7.794,39.394,21.243,P=0.007,0.005,P<0.001).Multivariate Logistic regression analysis showed that number of puncture(OR=6.442,95%CI:1.851-22.420,P=0.003)and abscess in central area(OR=2.643,95%CI:1.480-4.721,P=0.001)were the risk factors for delactation,while long postnatal time was a protective factor for delactation(OR=0.540,95%CI:0.315-0.927,P=0.025).Conclusions Ultrasound-guided aspiration and irrigation is effective for the treatment of lactational breast abscess,with a high cure rate and low delactation rate.The disease in puerperium,multiple punctures and the abscess in the central area are more likely to cause delectation.

关 键 词：乳腺疾病 脓肿 穿刺术 方法 

分 类 号：R737.9[医药卫生—肿瘤]