中药外敷与静脉导管留置针闭式引流治疗及护理急性化脓性乳腺炎

External application of Chinese medicine combined with closed drainage by indwelling needle through venous catheter in treatment of acute purulent mastitis

目的客观评价中药外敷联合静脉导管留置针闭式引流对于急性化脓性乳腺炎的疗效。方法记录并分析本院2014年7月12日至2015年8月12日收治的74例急性化脓性乳腺炎患者的数据及相应的临床资料，将其随机分为中药外敷联合静脉导管留置针闭式引流组（试验组）与传统切开引流组（对照组），各37例；试验组给予静脉导管留置针闭式引流及中药外敷，2次／天（早上八点敷药，下午四点换药），传统切开组给予传统切开引流术；对两组患者的疗效、体温恢复时间、白细胞恢复时间、复发率等进行比较。结果试验组患者治愈率为75．7％，有效率为18．9％，无效率为5．4％，总有效率为94．6％；对照组患者的治愈率为59．4％，有效率为32．4％，无效率为8．1％，总有效率为91．9％；两组差异具有统计学意义（t=10．54，P=0．037）；经过1周治疗及护理后，试验组患者体温恢复时间（1．78±0．65）h，白细胞恢复时间（23．8±6．54）h，复发率为5．4％；对照组患者的患者体温恢复时间（4．97±0．71）h，白细胞恢复时间（32．1±7．49）h，复发率为8．1％；两组比较显示，试验组患者体温恢复时间差异具有统计学意义（t=6．43，P=0．001）；试验组白细胞恢复时间低于对照组，差异具有统计学意义（t=6．43，P=0．001）；复发率两组比较差异无统计学意义（t=23．71，P=0．085）。结论中药外敷联合静脉导管留置针闭式引流对于急性化脓性乳腺炎疗效安全肯定。

Objectives To explore the clinical effect of the external application of Chinese medicine combined with closed drainage by indwelling needle through venous catheter in treatment of acute purulent mastitis. Methods 74 patients with acute purulent mastitis treated at our hospital from July 12th, 2014 to December 8th, 2015 were selected and randomly divided into an experimental group and a control group, 37 for each group. The experimental group externally took Chinese medicine at 8 and 16 and were treated with drainage by indwelling needle through venous catheter. The control group were treated with incision drainage. The clinical efficacy, the times for body temperature and white blood cell recovering to normal, and the recurrent rate were compared between these two groups. Results The cured rate, effective rate, effectless rate, and total effective rate were 75.7%, 18.9%, 5.4%, and 94.6% in the experimental group and were 59.4%, 32.4%, 8.1%, and 91.9% in the control group, with statistical differences （t=10.54,P=0.037）. The times for body temperature and white blood cell recovering to normal and recurrent rate were （ 1.78±0.65 ） h, （ 23.8±6.54 ） h, and 5.4% in the experimental group and （ 4.97±0.71 ） h, （ 32.1±7.49 ） h, and 8.1% in the control group, with statistical differences （t=6.43, P=0.001; t=6.43, P=0.001; and t=-23.71, P=0.085）. Conclusion The external application of Chinese medicine combined with closed drainage by indwelling needle through venous catheter in the treatment of acute purulent mastiffs is effective and safe.