20例肉芽肿性乳腺炎临床诊疗分析

Analysis of the Clinical Diagnosis and Treatment of 20 Cases of Granulomatous Mastitis

目的:探讨肉芽肿性乳腺炎的诊断及治疗方法。方法:回顾性分析2012年1月-2014年6月笔者所在医院收治的20例经病理确诊的肉芽肿性乳腺炎患者资料,归纳总结其临床特点及治疗效果。结果:10例患者初始治疗为病灶扩大切除,全部治愈,随访期间复发2例。5例患者应用糖皮质激素作为初始治疗,治愈4例,随访期间1例复发。5例患者初始治疗为脓肿切开引流,3例治愈,随访期间3例均复发。结论:肉芽肿性乳腺炎目前的治疗策略尚存在争议,在没有合并脓肿或瘘管、弥漫性病变时,病灶局部扩大切除是较确切的治疗方法。

Objective： To discuss the diagnosis and treatment method of granulomatous mastitis.Method： Twenty cases of granulomatous mastitis with pathologically confirmed admitted to our hospital from January 2012 to June 2014 were selected as the objects, the clinical manifestation and treatment effect of whom were retrospectively analyzed.Result： Wide local excision was performed in 10 patients, which were all healed completely, but with 2 cases relapsed during the follow-up.Steroid therapy was the initial treatment in 5 patients, in which 4 cases were healed completely, with 1 case relapsed during the follow- up.Incisional biopsy with abscess drainage was performed in 5 patients, in which 3 cases were healed completely, but all the 3 cases relapsed during the follow-up.Conclusion： The optimal treatment of granulomatous mastitis remains controversial.ff patients＇ clinical manifestation of granulomatous mastitis have no concurrent abscess, fistula or diffuse involvement, the wide local excision maybe a ideal treatment method.