浆细胞性乳腺炎外科治疗方法初步探索(附62例报告)

Analysis of Surgical Treatment for Plasma Cell Mastitis(A Report of 62 Cases)

目的探讨不同时期浆细胞性乳腺炎的治疗方法及其疗效。方法62例浆细胞性乳腺炎患者中,根据疾病的不同阶段采取不同的处理方式：因导管扩张行溢液乳段切除术24例（38.7%）,因急、慢性炎症行乳腺区段切除术11例（17.7%）,因脓肿形成行B超引导下乳腺脓肿穿刺冲洗术8例（12.9%）,脓肿置管引流术4例（6.5%）,脓肿切开引流10例（16.1%）,因瘘管或窦道形成行瘘管或窦道切除术5例（8.1%）。结果乳腺导管扩张期、急慢性炎症期行溢乳段切除、乳腺区段切除的35例均愈合,脓肿形成期的22例中,2例经3次脓肿穿刺冲洗未愈而改行切开引流术,余均痊愈,但行脓肿切开引流术的10例中复发4例（6.5%）;窦道期的5例经1-10个月换药痊愈。结论对于浆细胞性乳腺炎不同的阶段应选择适当的治疗方法,避免贸然采取乳腺单纯切除术,可使患者手术创伤减小,生活质量提高。

Objective To evaluate the effect of the surgical treatment for the plasma cell mastitis.Methods Different operations were performed in 62 patients according to different stages of plasma cell mastitis.Segment resection was used in 24 cases of liquorrhoea,partial mastectomy in 11 of acute or chronic inflammation.And for mammary abscess,puncture and douching guided by ultrasonic was used in 8,abscess tube drainage in 4 and abscess incision drainage in 10.Finally,in the 5 cases of fistula and sinus,the fistula and sinus tract resection was used.Result All the cases cured except 4 of the mammary abscess relapsed.Conclusion It is effective to take different treatments at different stages of plasma cell mastitis.It should be avoid undergoing the mammectomy intrusively.