术前应用小剂量泼尼松对肉芽肿性乳腺炎患者术后复发的影响和安全性分析  

Effects and safety of preoperative low-dose prednisone on postoperative recurrence in patients with gran-ulomatous mastitis

作　　者：吕梦 张斌[1] Lyu Meng;Zhang Bin(Department of Thyroid and Breast Surgery,Jiyuan People′s Hospital,Jiyuan,Henan 459000,China)

机构地区：[1]济源市人民医院甲乳外科,河南济源459000

出　　处：《中国药物与临床》2024年第20期1337-1340,共4页Chinese Remedies & Clinics

摘　　要：目的分析肉芽肿性乳腺炎患者在接受手术治疗前采用小剂量泼尼松的临床效果。方法选取2020年3月1日至2023年3月31日在河南省济源市人民医院诊治的96例肉芽肿性乳腺炎患者进行前瞻性研究。所有患者根据随机数字表法分为对照组(48例)和研究组(48例)。给予对照组患者醋酸泼尼松片治疗,初始剂量为0.75 mg·kg^(-1)·d^(-1),治疗5周后减量至5 mg/d,研究组给予患者醋酸泼尼松片治疗,初始剂量为0.4 mg·kg^(-1)·d^(-1),治疗5周后每周减量2.5 mg/d,最后将药物减量至5 mg/d,均进行为期2周的治疗,2组患者于治疗8周后进行手术切除术治疗。对比2组患者治疗效果,不良反应发生情况,治疗前后免疫功能相关指标以及并发症发生情况,2组均进行为期1年的随访,对比2组患者复发情况。结果对比2组患者药物治疗有效率、术后乳房外观满意率、术前服药时间、手术切除腺体量均差异无统计学意义(χ^(2)=0.274、0.089,t=0.785、0.562、0.962,P均>0.05);研究组患者胃部紊乱、月经紊乱、血糖升高、失眠不安发生较对照组减少(χ^(2)=7.940、8.491、7.144、8.317,P均<0.05),2组患者痤疮发生率差异无统计学意义(χ^(2)=0.174,P>0.05);治疗后2组患者CD3^(+)、CD4^(+)、CD8^(+)差异无统计学意义(P>0.05);2组患者并发症总发生率、复发率差异无统计学意义(χ^(2)=0.643、0.079,P均>0.05)。结论肉芽肿性乳腺炎患者在术前应用不同剂量的泼尼松效果相当,2组患者并发症、复发率均差异无统计学意义。小剂量泼尼松的应用可使不良反应的发生率下降,安全性较高,可为患者提供更经济高效的治疗,达到医疗机构安全有效、经济合理用药的目的。Objective To analyze the clinical effect of low-dose prednisone in patients with granulomatous mastitis before surgical treatment.Methods A prospective study was conducted on 96 patients with granuloma-tous mastitis diagnosed and treated at Jiyuan People′s Hospital from March 1,2020 to March 31,2023.All pa-tients were divided into a control group(48 cases)and a study group(48 cases)according to the random number table method.Patients in the control group were treated with prednisone acetate tablets at an initial dose of 0.75 mg·kg^(-1)·d^(-1),which was gradually reduced to 5 mg/d after 5 weeks of treatment.Patients in the study group were treated with prednisone acetate tablets at an initial dose of 0.4 mg·kg^(-1)·d^(-1),which was reduced 2.5 mg per week after 5 weeks of treatment,and finally to 5 mg/d.Both groups received a 2-weeks treatment.Surgical resection was performed on both groups 8 weeks after treatment.The treatment effects,occurrence of adverse reactions,immune function-related indicators before and after treatment,and complications of the two groups were compared.Both groups were followed up for 1 year,and the recurrence rates of the two groups were compared.Results There was no significant difference in treatment efficiency,satisfaction rate of breast appearance after surgery,preoperative medication time,sugical removal of gland volume between the two groups(χ^(2)=0.274,0.089,t=0.785,0.562,0.089,all P>0.05).The occurrence of gastric disorders,menstrual disorders,elevated blood glucose,restlessness in the study group was lower than that in the control group(χ^(2)=7.940,8.491,7.144,8.317,all P<0.05).There was no significant difference in the incidence of acne between the two groups(χ^(2)=0.174,P>0.05).After treatment,there was no statistically significant difference in CD3^(+),CD4^(+),and CD8^(+)between the two groups(P>0.05).There was no statistically significant difference in complications,and recurrence rate between the two groups(χ^(2)=0.643,0.079,both P>0.05).Conclusion The preoperative

关 键 词：泼尼松 肉芽肿性乳腺炎 复发 安全性 

分 类 号：R655.8[医药卫生—外科学]