新型疏通导管在哺乳期急性高张力性乳腺积乳囊肿治疗中的应用分析  

Application of a novel drainage catheter in treatment of acute high-tension breast milk cyst during lactation

作　　者：成芳[1] 薛筱蕾 胡慧文 王丽 顾娟芬 CHENG Fang;XUE Xiaolei;HU Huiwen;WANG Li;GU Juanfen(Obstetrics Department,the Fifth Affiliated Hospital of Xinjiang Medical University,Urumqi,Xinjiang,830011;Postpartum Rehabilitation Center,Changzhou Maternity and Child Health Care Hospital of Jiangsu Province,Changzhou,Jiangsu,213300;Postpartum Rehabilitation Center,Xishan People′s Hospital in Wuxi City of Jiangsu Province,Wuxi,Jiangsu,214105)

机构地区：[1]新疆医科大学第五附属医院产科,新疆乌鲁木齐830011 [2]江苏省常州市妇幼保健院产后康复中心,江苏常州213300 [3]江苏省无锡市锡山人民医院产后康复中心,江苏无锡214105

出　　处：《实用临床医药杂志》2025年第6期84-88,共5页Journal of Clinical Medicine in Practice

基　　金：江苏省无锡市卫健委妇幼健康适宜技术推广项目(FYTG201807)。

摘　　要：目的基于乳管解剖结构制备新型疏通导管,并建立哺乳期急性高张力性乳腺积乳囊肿患者的无创疏通治疗方案。方法收集3家医院产后门诊收治的10例哺乳期急性高张力性乳腺积乳囊肿患者作为研究对象,均为初产妇。使用硬膜外麻醉导管制备新型疏通导管,插管疏通阻塞乳管,疏通未成功者改用穿刺抽吸,治疗后均对乳房进行局部冷敷。结果10例患者中,6例疏通成功(疏通成功组),4例疏通失败(疏通失败组)。疏通成功组患者的病程为(6.00±0.82)d,短于疏通失败组的(9.50±1.80)d,导管插入深度为(6.42±0.67)cm,大于疏通失败组的(4.00±0.71)cm,差异有统计学意义(P<0.05);2组肿块直径比较,差异无统计学意义(P>0.05)。疏通未成功者改用穿刺抽吸,其中3例在首次穿刺后复发,行超声引导下再次穿刺抽吸并断乳;1例患者炎症症状明显,给予全身抗生素治疗。治疗后,7例患者恢复哺乳,复诊结果显示10例患者均痊愈。结论哺乳期急性高张力性乳腺积乳囊肿在临床中较为少见,新型疏通导管可实现对乳窦部远端阻塞乳管的无创疏通,综合治疗方案可提高总体治愈率,治疗后恢复哺乳率较高。Objective To develop a novel drainage catheter based on the anatomical structure of the mammary duct and establish a non-invasive treatment protocol for patients with acute high-tension breast milk cyst during lactation.Methods Ten primiparous patients with acute high-tension breast milk cyst during lactation,admitted to the postpartum clinics of three hospitals,were enrolled as study subjects.A novel drainage catheter was prepared using an epidural anesthesia catheter,and intubation was performed to unblock the obstructed mammary ducts.For cases with intubation failure,puncture aspiration was employed.Local cold compresses were applied to the breasts after treatment.Results Out of 10 patients,6 were successfully unblocked(successful group),and 4 failed(failure group).The duration of illness in the successful group was(6.00±0.82)days,which was shorter than that in the failure group[(9.50±1.80)days](P<0.05).The insertion depth of the catheter in the successful group was(6.42±0.67)cm,which was greater than that in the failure group[(4.00±0.71)cm](P<0.05).There was no statistically significant difference in cyst diameter between the two groups(P>0.05).For patients in whom unblocking failed,puncture aspiration was performed,and 3 of them experienced recurrence after the initial puncture.Ultrasound-guided re-puncture aspiration and weaning were performed.One patient with evident inflammatory symptoms was administered systemic antibiotic therapy.After treatment,7 patients resumed lactation,and follow-up results indicated that all 10 patients were cured.Conclusion Acute high-tension breast milk cyst during lactation is relatively rare in clinical practice.The novel drainage catheter can achieve non-invasive unblocking of distally obstructed mammary ducts in the lactiferous sinus.The comprehensive treatment protocol can improve the overall cure rate and result in a high rate of resumed lactation post-treatment.

关 键 词：哺乳期 急性高张力性乳腺积乳囊肿 新型疏通导管 硬膜外麻醉导管 无创疏通 穿刺抽吸 乳腺疾病 初产妇 

分 类 号：R714.6[医药卫生—妇产科学] R605[医药卫生—临床医学] R319