CAJ | 학술논문

目的：探讨应用麦默通微创旋切术加置管引流治疗乳腺炎性疾病的临床疗效。方法回顾性分析郑州大学附属郑州中心医院乳甲外科2009年6月至2012年12月收治的95例超声及临床检查诊断为急、慢性乳腺炎伴脓肿形成的女性患者的临床资料,所有患者均于炎症局限后在超声引导下行乳腺炎性病灶麦默通微创旋切术加置管引流治疗。结果95例患者均采用麦默通微创旋切术加置管引流,超声均能清晰显示微创旋切病灶及脓液抽吸过程,术后置管引流约5~7 d,治愈率为97．9%(93/95)。其中4例患者术后出现少量皮下淤血,平均7~14 d后缓慢自行吸收。术后3、6个月分别复查超声,均提示切除完全,愈合良好；2例合并浆细胞性乳腺炎的患者分别于术后13、15个月复发,复发率为2．1%(2/95),再次行开放性手术后治愈。其中3例涉及2个以上象限的巨大脓肿经本方法治疗,术后置管引流7 d,均愈合良好,随访未见复发。95例患者的脓液标本均经细菌培养,阳性率为70．5%(67/95)；切除标本病理结果均为乳腺炎性病变。结论超声引导下麦默通微创旋切术加置管引流治疗急、慢性哺乳期及非哺乳期乳腺炎伴脓肿形成的患者,其疗效均可靠,值得临床推广。
목적：탐토응용맥묵통미창선절술가치관인류치료유선염성질병적림상료효。방법회고성분석정주대학부속정주중심의원유갑외과2009년6월지2012년12월수치적95례초성급림상검사진단위급、만성유선염반농종형성적녀성환자적림상자료,소유환자균우염증국한후재초성인도하행유선염성병조맥묵통미창선절술가치관인류치료。결과95례환자균채용맥묵통미창선절술가치관인류,초성균능청석현시미창선절병조급농액추흡과정,술후치관인류약5~7 d,치유솔위97．9%(93/95)。기중4례환자술후출현소량피하어혈,평균7~14 d후완만자행흡수。술후3、6개월분별복사초성,균제시절제완전,유합량호；2례합병장세포성유선염적환자분별우술후13、15개월복발,복발솔위2．1%(2/95),재차행개방성수술후치유。기중3례섭급2개이상상한적거대농종경본방법치료,술후치관인류7 d,균유합량호,수방미견복발。95례환자적농액표본균경세균배양,양성솔위70．5%(67/95)；절제표본병리결과균위유선염성병변。결론초성인도하맥묵통미창선절술가치관인류치료급、만성포유기급비포유기유선염반농종형성적환자,기료효균가고,치득림상추엄。
Objective To investigate the clinical efficacy of vaccum-assisted mammotome minimally invasive system plus catheter drainage in the treatment of mastitis. Methods We retrospectively analyzed 95 females with acute or chronic mastitis plus abscess confirmed by ultrasound and clinical examination in our Department of Breast and Thyroid Surgery, Zhengzhou Central Hospital Affiliated to Zhengzhou University from June 2009 to December 2012. For all the patients, the lesions of mastitis were excised by mammotome minimally invasive system under the guidance of ultrasound, and then the drainage was applied. Results The ultrasonography clearly demonstrated the procedure of lesion excision and abscess aspiration. The catheter drainage was maintained for about 5 to 7 days after operation. Four patients had slight subcutaneous congestion, which was self-absorbed slowly 7 to 14 days later. The ultrasound reexamination at postoperative 3 and 6 months showed that all the lesions were completely resected and the wounds healed well. Two cases of plasma cell mastitis reoccurred 13 and 15 months after operation respectively ( 2. 1%, 2/95 ) , so they underwent open surgery and recovered. Three patients with huge abscess involving more than 2 quadrants were treated by mammotome system plus catheter drainage for more than 1 week after operation. They healed well, with no recurrence in follow-up period. Bacterial culture showed that positive rate of pus specimens was 70. 5% (67/95);and the pathological diagnosis confirmed inflammatory lesions in all patients. Conclusion Ultrasound guided minimally invasive incision with mammotome system plus catheter drainage is effective in treatment of acute or chronic lactating or non-lactating mastitis combined with abscess, worthy of clinical application.