超区段切除治疗脓肿型浆细胞性乳腺炎的临床效果

Effect of large segment resection on abscess type of plasma cell mastitis

目的探讨超区段切除在脓肿型浆细胞性乳腺炎手术中的应用效果。方法回顾性分析脓肿型浆细胞型乳腺炎超区段切除手术治疗并I期缝合切口198例患者的资料,平均年龄44岁（16~55岁）,左侧107例,右侧89例,双侧2例。病灶范围直径约2~7cm。病程2个月~2年。术前均予抗生素及地塞米松抗炎抗感染控制病灶,术中彻底切除受累皮肤、破溃皮肤、穿刺点、切除所有肉眼可见的病变组织,包括受累皮下组织、脂肪、病变腺体,切除距离病灶边缘〉2cm。过大残腔可使用周边正常腺体组织填充,尽可能减少乳腺外形的改变。术后全部病例均经病理证实。结果198例脓肿型浆细胞型乳腺炎患者行超区段切除术并I期缝合切口,组织病理诊断为浆细胞性乳腺炎,可见导管扩张伴浆细胞浸润。其中196例治愈,2例未能I期愈合,经进一步抗炎抗感染、换药2周后治愈。乳头无明显变形及切口感染;随访1~3年,无复发病例。结论超区段切除手术并I期缝合切口治疗脓肿型浆细胞性乳腺炎疗效确切,可避免II期全乳腺切除及复发,部分患者在术中局部整形亦可取得良好满意外形。

Objective To investigate the application of large segment resection on abscess type of plasma cell mastitis.Methods 198 patients with abscess type of plasma cell mastitis treated with large segment resection were respectively analyzed.The age of the patients was 44years（16y-55y）.The diameter of the lesion was 2-7cm.The course of disease was 2months to 2years.The patients were treated with antibiotics to control infection and hexadecadrol to control inflammatory before operation.The involved skin and pathological tissues including subcutaneous tissue,fat and gland were thoroughly exsected.The distance of exsection was larger than 2cm away from the edge of lesion.The large cavity was filled with normal gland tissue.Results 198 patients were diagnosed as abscess type of plasma cell mastitis with pathology.There were 196 cases cured and 2cases without I phase healing.There was no recurrence followed up for1-3months.Conclusion The curative effect of super resection operation and I suture incision for the treatment of abscess type of plasma cell mastitis can avoid the phase II mastectomy and relapse.The patients in the intraoperative local plastic can also be achieved good satisfactory appearance.