置管引流与微创旋切对哺乳期乳腺脓肿患者炎性因子及免疫功能的影响  

Effects of Catheter Drainage and Mammotome Minimally Invasive Surgery on Inflammatory Factors and Immune Function in Lactational Breast Abscess Patients

作　　者：温素奇 江涛[2] 温革新 张国辉 张国生 WEN Suqi;JIANG Tao;WEN Gexin;ZHANG Guohui;ZHANG Guosheng(Ganzhou Hospital of Guangdong Provincial People's Hospital(Ganzhou Municipal Hospital),Ganzhou 341000,China;The First Affiliated Hospital of Gannan Medical College,Ganzhou 341000,China)

机构地区：[1]广东省人民医院赣州医院(赣州市立医院),江西赣州341000 [2]赣南医学院第一附属医院,江西赣州341000

出　　处：《中国医药指南》2023年第20期71-73,共3页Guide of China Medicine

基　　金：赣州市指导性科技计划项目(GZ2020ZSF399)。

摘　　要：目的比较置管引流术与微创旋切术对哺乳期乳腺脓肿患者炎性因子及免疫功能的影响。方法将64例哺乳期乳腺脓肿患者随机分为对照组和观察组,每组32例。对照组行超声引导下置管引流,观察组行麦默通微创旋切术。分别检测两组患者术前和术后第3天的白细胞(WBC)计数、C反应蛋白(CRP)、降钙素原(PCT)、白细胞介素6(IL-6)、白细胞介素8(IL-8)、肿瘤坏死因子α(TNF-α)、T淋巴细胞(CD_(4)^(+)和CD_(8)^(+))及免疫球蛋白(IgG和IgM)水平,并进行比较。结果观察组术后的CRP、IL-6、IL-8、TNF-α、IgG和IgM水平均较同期的对照组的水平下降更明显(P<0.05)。术后第5天两组患者脓肿愈合情况比较:对照组出现4例脓肿引流不尽以及1例乳漏[15.63%(5/32)],观察组出现1例切口感染[3.13%(1/32)],差异无统计学意义(P>0.05)。结论对于哺乳期乳腺脓肿的治疗,超声引导下置管引流与微创旋切术均能较好控制乳腺炎症、感染。但微创旋切术能更快的降低炎性因子水平,且能改善免疫功能,缩短康复进程。Objective To compare the effects of two minimally invasive methods(ultrasound-guided catheter drainage and Mammotome minimally invasive surgery)on inflammatory factors and immune function in the treatment of lactational breast abscess patients.Methods Sixty-four patients with lactating breast abscess were randomly divided into control group and observation group,with 32 cases in each group.The control group underwent ultrasound-guided tube drainage,and the observation group Mammotome minimally invasive surgery.The white blood cell(WBC)count and C-reactive protein(CRP),procalcitonin(PCT)and interleukin 6(IL-6),interleukin 8(IL-8),tumor necrosis factor-α(TNF-α),T lymphocytes(CD_(4)^(+)and CD_(8)^(+))and immunoglobulin(IgG and IgM)were detected at preoperative and postoperative for all the patients.Results Compared between the two groups after treatment,the levels of CRP,IL-6,IL-8,TNF-α,IgG and IgM in the observation group decreased significantly compared with the control group in the same period(P<0.05).On the fifth postoperative day,the abscess healing of the two groups was compared:4 cases of incomplete abscess drainage and 1 case of milk leakage[15.63%(5/32)]in the control group and 3.13%(1/32)of incision infection in the observation group,the difference was not statistically significant(P>0.05).Conclusions For the treatment of mammary abscess in lactation,ultrasound-guided catheter drainage and Mammotome minimally invasive surgery can control mammary gland inflammation and infection.However,Mammotome minimally invasive surgery can reduce the level of inflammatory factors more quickly,improve immune function and shorten the rehabilitation process.

关 键 词：哺乳期乳腺脓肿 置管引流 麦默通微创旋切 炎性因子 免疫功能 

分 类 号：R655.8[医药卫生—外科学]