导管周围乳腺炎的外科治疗

Surgical management of periductal mastitis

目的总结导管周围乳腺炎的临床特点及手术治疗经验。方法回顾性分析108例乳腺导管周围乳腺炎患者的临床资料,探讨其临床特点及治疗方法。结果临床表现主要为乳晕周围肿块者45例,其中8例伴有乳头内陷,在病理诊断之前均未作出明确诊断,均经手术治愈。临床表现主要为乳腺导管瘘者54例,其中30例伴有乳头内陷,经1期手术治愈48例,伴有乳头内陷者同时做乳头内陷矫正。临床表现主要为乳腺脓肿者9例,其中急性脓肿5例,切开引流,2期手术治愈;乳晕旁慢性脓肿4例,1期病灶清除治愈。结论导管周围乳腺炎的临床表现主要为乳晕周围肿块、乳晕周围脓肿、乳腺导管瘘。其中以乳腺肿块为临床表现者,在病理诊断之前难以作出准确诊断,术中病理检查是确诊的可靠方法。外科手术是治疗的有效手段。

Objective To identify clinical characteristics of periductal mastiffs and corresponding surgical treatment. Methods The clinical data of 108 cases with periductal mastiffs were reviewed retrospectively ,clinical characteristics and effective treatment were discussed. Results Among the 45 patients with lumps around the areola, 8 presented with nipple inversions. This group were not definitely diagnosed before surgery but completely cured thereafter. Among the 54 patients with mammary duct fistulae, 30 patients presented with nipple inversions. The first stage surgery helped to cure 48 patients, among whom correction of nipple inversions were given to the relevant ones. Among 9 patients with mammary abscess, 5 patients were acute and cured at the second stage surgery through incision and drainage. 4 patients presented with chronic abscess near the areola and were cured through the first stage surgery. Conclusions The main clinical characteristics of periductal mastitis are presented with lumps or abscess around the areola and duct fistulae. Patients affected with lumps around the areola are difficult to confirm diagnose before pathological examination. On the contrary, pathological examination during the surgical treatment is accurate and therefore reliable. Surgical treatment is an efficient method to the disease.