浆细胞性乳腺炎再次手术原因分析及治疗研究

Analysis on Reason of Plasma Cell Mastitis Reoperation and Study on the Treatment

目的探讨浆细胞性乳腺炎需要再次手术的原因、手术时机的选择以及相应的手术方法。方法选择2010年12月至2012年12月北京市怀柔区中医医院收治的26例复发性浆细胞性乳腺炎患者作为研究对象，对其复发原因，治疗时机选择以及治疗方法进行分析。结果26例患者中有14例患者（53．84％）因乳房脓肿而需多次切开引流手术、6例患者（23．08％）因肿块切除后再次出现或不愈合、6例患者（23．08％）术后乳晕部炎症多次发作且面积相对较大而需再次实施手术治疗。对于处于炎症期的患者予以消炎治疗，对于乳房脓肿患者行脓肿切开引流，缩小炎症范围后再予手术治疗。手术治疗时需切除包括溃疡周围1cm正常的皮肤组织以及病变乳管，术后随访9～50个月均无复发现象。结论浆细胞性乳腺炎再次复发的原因主要与临床医师对本病认识不够、处理方法不当等有关，再次手术治疗时应把握手术时机，完全切除病变组织，并对受累的乳管进行处理，以有效地降低再次手术的风险，防止再次复发。

Objective To investigate the reasons of plasma cell mastitis reoperation, operation timing selection and operation methods. Methods Total of 26 recurrent plasma cell mastitis patients in Huairou District Chinese Medicine Hospital of Beijing from Dec. 20101to Dec. 2012 were selected ,and the relapse reason, treatment timing and methods of treatment were analyzed. Results Among the 26 patients, 14 patients （53.84%） were due to breast abscess requiring multiple incision and drainage,6 patients（23.08% ） were due to lump reappearance or disunion, 6 patients （23.08 % ） were due to multiple episodes of areola papillaris inflammation with relatively large area involved needing surgery treatment. For the patients in inflammatory phase anti-inflammatory treatment was given first, galactapostema was given incision and drainage, to shrink inflammation Scope and then surgery can be done. The surgery scope should include 1 cm of peripheral normal skin tissue and pathological lacticiferous vessel, during the follow-up of 9 to 50 months, there was no recurrence. Conclusion The reasons of plasma cell mastitis relapse are mainly clinicians＇ lack of awareness of the disease,improper treatment. As for reoperation the timing of surgery should be well selected, to realize complete removal of the lesion tissue, and the affected lacticiferous vessel should be treated to reduce the risk of reoperation and prevent relapse.