脓肿型浆细胞性乳腺炎二次手术必要性研究

刘云峰 唐华明

摘   要：目的  研究膿肿型浆细胞性乳腺炎的二次手术必要性。方法  收集2011年1月～2016年6月我院收治肿型浆细胞性乳腺炎118例，其中单纯行脓肿切开引流65例，乳腺腺叶切除32例，乳腺象限切除21例，单纯行脓肿切开引流为对照组，余为实验组，对两组患者的住院时间、切口愈合时间、手术瘢痕大小、切口愈合等级、乳房变形情况及术后1年内的复发情况等相关临床资料进行回顾性分析。结果  试验组患者住院时间、切口愈合时间均少于对照组，组间比较差异有统计学意义（P<0.05）;实验组手术瘢痕大小、术后1年内的复发情况及乳房发生变形情况明显少于对照组，差异有统计学意义（P<0.05）;切口愈合等级实验组优于对照组，差异有统计学意义（P<0.05）。结论  脓肿型浆细胞性乳腺炎二次手术能够明显缩短患者住院时间及切口愈合时间，减轻了患者痛苦，术后乳房变形小、瘢痕面积长度减短，切口愈合效果好，美容效果好，减少短期复发。

关键词：脓肿型浆细胞性乳腺炎;二次手术;二次手术必要性

中图分类号：R655.8                                  文献标识码：A                                DOI：10.3969/j.issn.1006-1959.2018.05.031

文章编号：1006-1959（2018）05-0096-03

Necessity of Secondary Surgery for Abscess-type Plasma Cell Mastitis

LIU Yun-feng，TANG Hua-ming

（Department of General Surgery，Two Subjects，Chongqing Kaizhou District People's Hospital，Chongqing 400000，China）

Abstract：Objective  To study the necessity of secondary operation for abscess type plasma cell mastitis.Methods  118 cases of abscess type plasmacytic mastitis were treated in our hospital from January 2011 to June 2016.Among them，65 cases were treated with abscess incision and drainage，32 cases were treated with mammary gland lobectomy.21 cases of mammary gland quadrant resection were treated with abscess incision and drainage as control group，and the rest with experimental group.The clinical data such as hospitalization time，wound healing time，scar size，wound healing grade，breast deformation and recurrence within 1 year after operation were analyzed retrospectively.Results  The experimental group hospitalization time and wound healing time were less than the control group，there were significant differences between the groups（P<0.05）;the experimental group postoperative scar size and postoperative recurrence of breast and 1 years occurrence of deformation was less than the control group，the difference was statistically significant （P<0.05）;wound healing grade the experimental group than the control group，the difference was statistically significant（P<0.05）.Conclusion  The second operation of abscess plasmacytic mastitis can significantly shorten the time of hospitalization and wound healing，alleviate the pain of the patients，reduce the deformation of the breast，shorten the scar area，improve the healing effect of the incision，and the cosmetic effect is good，reduce short term recurrence.

Key words：Abscess type plasma cell mastitis;Secondary operation;Necessity of secondary operation

浆细胞性乳腺炎（plasma cell mastitis，PCM），亦称为管周性乳腺炎或乳腺导管扩张症，多见于非哺乳期中青年妇女，是一种非感染性、特殊类型乳腺良性疾病，临床上以乳房肿块、乳头溢液或两者均有多见。其发病率约占乳腺良性疾病的1.41%～5.36%，占乳房疾病的2%，因该病复杂多样的临床表现，故要与其他乳腺疾病相鉴别甚为困难，通常误诊率可高达56.9%～73.1%[1]，PCM是非哺乳期乳腺炎中临床处理较困难的类型之一，若处理不及时或方法不当，容易行成乳管瘘，经久不愈，治愈后复发率增高，因此PCM一经确诊，尤其是脓肿形成，对脓肿型浆细胞性乳腺炎，治疗方案，临床上仁者见仁，智者见智，现尚未达成共识，本研究就我院既往病例中相关资料进行分析，初步探讨二次手术的必要性。

1 资料与方法

1.1一般资料  回顾性分析重庆开州……