66例哺乳期乳房脓肿超声介入治疗分析

Breast Abscess in Lactating Women:US-guided Interventional Therapy of 66 Cases

目的探讨超声引导介入治疗哺乳期乳房脓肿的疗效。方法回顾性评估66例患者78个乳房脓肿采用超声引导下穿刺抽脓或Mammotome微创治疗的临床效果。结果超声引导穿刺抽脓治疗(穿刺组)37例,35例治愈,2例失败转开放手术。超声引导Mammotome微创治疗(MMT组)31例,均获治愈。两组总治愈率比较,不具有统计学差异(P>0.05)。把脓液量作为分层因素进一步分析,脓液量≤30 ml时,穿刺组与MMT组均能获得治愈,但穿刺组的整体费用明显较MMT组低,具有统计学差异(P<0.05)。脓液量>30 ml时,两组患者治愈情况存在显著差异,MMT组优于穿刺组,具有统计学意义(P<0.05),但穿刺组的医疗费用较低(P<0.05)。此外,无论是否将脓液量作为单因素分析,两组患者在治疗时间与对治疗刺激的疼痛不适方面没有明显差异(P>0.05)。结论超声引导的穿刺抽脓治疗与Mammotome微创治疗都是可行的。脓液量是影响乳房脓肿超声介入治疗方法选择的重要因素,脓液≤30 ml时选择穿刺抽脓治疗在保证治疗效果前提下,治疗成本更低;>30 ml时,Mammotome微创治疗治愈率更高。

Objective To estimate the value of uhrasonography （US）-guided interventional therapy of breast abscess in lactating women. Methods 66 cases of 78 breast abscess in lactating women were treated with US-guided interventional therapy, by aspiration or the Mammotome therapy. Their clinical results were retro- spectively studied. Results In the Mammotome therapy group all 31 patients were treated successfully. In the aspiration group, 35 patients were successfully treated while 2 patients did not heal following aspiration and subse- quently required incision and drainage. Compared the effect of the two therapies, there was no significant difference（P 〉0.05）. However, when considering the factor of pus volmne, all of abscess with the pus volume ≤30ml were treated by aspiration or the Mammotome therapy successfully, between which the former got lower hospital cost （P 〈0.05）. All of abscess with the pus volume 〉 30ml were treated more effectively by the Mammotome therapy, and there was obviously different between the effect of aspiration and the Mammotome therapy（P 〈0. 05）. In addi- tion , regardless of the factor of pus volume ,the degree of pain and treatment time between the two therapies were not significantly different （P 〉 0.05）. Conclusion Breast abscess could be treated successfully with US-guided interventional therapy, by aspiration or the Mammotome therapy. Pus volume is an important factor which influences the treatment choice. Aspiration of breast abscess with 30 ml or less pus could be more economic on the basis of therapy effect. It is more effective to use the Mammotome therapy for breast abscess with more than 30 ml pus.