肉芽肿性乳腺炎手术治疗的回顾性研究  

Retrospective study of surgical treatment of granulomatous mastitis

作　　者：孙全武[1] 郭千弘 李光勇 郝杰[1] 杜小平[1] 黄海云[1] SUN Quanwu;GUO Qianhong;LI Guangyong;HAO Jie;DU Xiaoping;HUANG Haiyun.(Department of Breast Surgery,People′s Hospital of Gansu Province, Lanzhou 730000,China;Department of Oncological Surgery,the First People′s Hospital of Tianshui City;Department of General Surgery,Lintan Branch of People′s Hospital of Gansu Province)

机构地区：[1]甘肃省人民医院乳腺外科,甘肃兰州730000 [2]天水市第一人民医院肿瘤外科 [3]甘肃省人民医院临潭分院普外科

出　　处：《西北国防医学杂志》2020年第12期749-753,共5页Medical Journal of National Defending Forces in Northwest China

摘　　要：目的:探讨皮质类固醇激素对肉芽肿性乳腺炎患者手术疗效的影响。方法:选择2009-01-01~2016-08-01住院治疗的肉芽肿性乳腺炎患者61例,所有患者均行乳腺病变组织扩大切除术,并经病理检查确诊。根据是否使用激素分为未使用激素组(n=37)和激素治疗组(n=24)。比较两组平均手术时间、术中失血量、术后伤口愈合时间、并发症发生情况等。术后随访2年,分析手术疗效。结果:未使用激素组术后伤口彻底愈合时间为(37.25±14.89)d,短于激素治疗组的(63.65±31.59)d,差异有统计学意义(P<0.05)。两组的平均手术时间,术中失血量等比较,差异无统计学意义。术后第1年随访,未使用激素组2例复发,激素治疗组1例复发,均行二次手术后治愈;术后第2年随访,两组均无复发。结论:肉芽肿性乳腺炎是比较特殊的乳腺炎,单纯影像学检查难以诊断,病理检查可以明确诊断。乳腺病变组织扩大切除术治疗该病安全可行,但皮质类固醇激素引起的伤口愈合延迟等并发症应该引起足够重视,其治疗带来的获益需要多中心临床试验来证实。Objective:To investigate the effect of corticosteroids on the surgical outcome in patients with granulomatous mastitis(GM).Methods:Sixty-one patients with GM in our hospital from January 2009 to August 2016 were selected.All patients underwent expanded resection of breast lesions,and they were confirmed by pathological examination.According to whether use hormones or not,all patients were divided into the non-hormone group(n=37)and hormone therapy group(n=24).The mean operation time,intraoperative blood loss,postoperative wound healing time and occurrence of complications between the two groups were compared.The patients were followed up for 2 years,and the curative effect was analyzed.Results:The postoperative wound healing time of the non-hormone group was(37.25±14.89)d,which was shorter than that of the hormone therapy group(63.65±31.59)d,the difference was statistically significant(P<0.05).There was no significant difference in mean operation time and intraperative blood loss.During the first year of follow-up,2 patients recurrenced in non-hormone group,1 patient recurrenced in hormone therapy group,all patients were cured after the second operation.During the second year of follow-up,there was no recurrence between the two groups.Conclusion:GM is a more specific type of mastitis,imaging examination alone is difficult to diagnose,pathological examination can confirm the diagnosis.Enlarged mastectomy is safe and feasible for the treatment of breast tissue,however,complications such as delays wound healing caused by corticosteroids should be paid more attention,and the benefit of the treatment should be confirmed by multi-center clinical trials.

关 键 词：乳腺 肉芽肿性乳腺炎 皮质类固醇激素 治疗 

分 类 号：R737[医药卫生—肿瘤]