超声引导下麦默通elite穿刺诊治脓肿期浆细胞性乳腺炎的临床价值

Ultrasound guided Mammotome elite biopsy in the diagnosis and treatment of abscess stage of plasma cell mastitis

目的探讨超声引导下行麦默通elite穿刺诊治脓肿期浆细胞性乳腺炎的临床价值。方法 40例脓肿期浆细胞性乳腺炎在超声引导下行麦默通elite穿刺活检。麦默通elite先穿刺肿块低回声区,穿出组织送病理检查,再穿刺肿块内无回声区,抽出大部分脓液并送细菌培养及药敏。穿刺结束后通过麦默通elite的穿刺口注入生理盐水冲洗脓腔。病理明确为浆细胞性乳腺炎后开始中药温阳通络方剂治疗。比较穿刺前后脓腔及肿块大小值的变化及并发症发生情况。结果 40例患者均穿刺成功,无明显不良反应发生,均经病理诊断为浆细胞性乳腺炎。40例患者的脓腔大小平均值穿刺后较穿刺前明显减小,差异有统计学意义(P<0.05);而肿块大小平均值穿刺后较穿刺前变化不明显(P>0.05)。2例患者的脓液中培养出金黄色葡萄球菌生长;1例患者的脓液中培养出厌氧菌生长;余37例患者的脓液细菌培养均无细菌生长。穿刺后给予温阳通络方剂治疗,平均疗程87天,均临床治愈。结论超声引导下麦默通elite穿刺活检操作简单安全,诊断准确率高。在明确诊断的同时对脓腔可以充分引流。在充分引流后,予以中药温阳通络方治疗对脓肿期浆细胞性乳腺炎有显著疗效,可在临床推广应用。

Objective To investigate the clinical value of ultrasound guided Mammotome elite biopsy in the diagno- sis and treatment of abscess stage of plasma cell mastitis. Methods 40 paitents of abscess stage of plasma cell mastitis were biopsy with Mammotome elite under Ultrasound guided. Low echo area was punctured and tissues were sent to pathological examination. After that, no echo area was punctured and most of the pus which was sent to bacteria culture and drug sensitivity was extracted. After the puncture, normal saline was injected to the abscess cavity through the cut by Mammotome elite. After the pathological diagnosis of plasma cell mastitis, traditional Chinese medicine Wenyang Tongluo recipe was given for treatment. The complications were observed before and after puncture, and the size of the abscess cavity and mass were recorded. Results 40 cases were successfully treated with no obvious adverse reaction and all were by the pathological diagnosis of plasma cell mastitis. The average size of the 40 patients＇abscess cavity was de- creased after biopsy and the difference was statistically significant（P〈0.05）. The average size of the mass was not signif- icantly changed after the puncture（P〉0.05）. The pus in 2 patient was fostered the growth of staphylococcus aureus and the pus in 1 patient was fostered the growth of anaerobe, while other 37 cases of patients with pus bacterial culture showed no bacterial growth. The patients were given Wenyang Tongluo recipe in treating after biopsy. All were clinical cured and the average duration was 87 days. Conclusion Ultrasound guided Mammotome elite biopsy with high rate of ac- curacy in diagnosis is simple and safe. Diagnosis at the same time adequate drainage to abscess cavity can be made. After full drainage, Wenyang Tongluo recipe is effective in the treatment of abscess stage of plasma cell mastitis, and can be used in clinical application.