肉芽肿性乳腺炎临床诊治探讨

Clinical Diagnosis and Treatment of Granulomatous Mastitis

目的探讨肉芽肿性乳腺炎的临床诊治措施。方法选取2012年4月—2015年9月该院收治的40例肉芽肿性乳腺炎患者,根据患者的临床病理特征进行治疗。结果 40例患者均通过病理学诊断为肉芽肿性乳腺炎,5例患者经微创术后病理确诊,手术后使用甲硝唑+广谱抗菌药物治疗1周;22例患者经过术前空心针穿刺和术后病理确诊,13例患者经过术中冰冻病理学检查和常规病理检查确诊。共有32例患者采用甲硝唑+广谱抗菌药物进行治疗,对30例患者进行随访4~28个月,平均随访(11.4±2.2)个月,30例患者中仅有1例患者对侧乳房复发,其余患者术后恢复良好;4例脓肿患者患处切开排脓后,进行细菌培养检查,没有发生细菌生长等情况。结论肉芽肿性乳腺炎患者主要通过手术治疗,且治愈情况良好,随访预后不良情况少见。

Objective To investigate the clinical diagnosis and treatment of granulomatous mastitis. Methods 40 patients with granulomatous mastitis treated in our hospital from April 2012 to September 2015 were selected and treated according to their clinical and pathological characteristics. Results 40 patients with pathological diagnosis of granulomatous mastitis, 5 patients underwent minimally invasive postoperative pathological diagnosis, postoperative use of metronidazole and broad-spectrum antibiotic therapy for 1 weeks; 22 patients after preoperative core needle biopsy and postoperative pathological diagnosis, 13 cases of patients after intraoperative frozen pathological examination and routine pathology confirmed. A total of 32 patients were treated with metronidazole and broad-spectrum antibacterial drugs for treatment, they were followed up for 4 to 28 months in 30 cases, the average follow-up（11.4±2.2） months. In 30 patients, contralateral breast recurrence only 1 patients, all patients recovered well after operation; 4 cases of patients with skin abscess incision and drainage. Check for bacterial culture, no bacterial growth. Conclusion The patients with granulomatous mastitis are mainly treated by surgery, and the prognosis is good.