浆细胞性乳腺炎115例治疗回顾性分析

Retrospective Analysis on Plasma Cell Mastitis: A Report of 115 Cases

目的 :回顾性分析115例浆细胞性乳腺炎患者的临床资料,比较手术、中药、中药结合手术3种治疗方法的临床疗效。方法:收集2013年1月—2015年12月中国中医科学院广安门医院外科115例具有完整病例资料的浆细胞性乳腺炎患者的门诊及住院病历信息。了解浆细胞性乳腺炎的临床特点和治疗情况,评价各治疗方法在临床疗效、治疗时间、对乳房外形影响程度方面的情况。结果:(1)115例患者中手术治疗者7例,占6.1%;中药治疗者89例,占77.4%;中药结合手术治疗者19例,占16.5%。(1)手术治疗的7例患者中,接受区段切除术2例,肿块切除术2例,化脓性感染切开引流术3例。(2)中药结合手术治疗的患者中,接受肿块切除术5例,接受区段切除术2例,接受化脓性感染切开引流术11例。(2)其中85例完全治愈患者依照3种治疗方法分为3组。3种治疗方法及治疗时间比较,差异有统计学意义(P<0.05)。手术组患者治疗前后患者症状体征评分比较,差异有统计学意义(P<0.05);中药组患者治疗前后患者症状体征评分比较,差异有统计学意义(P<0.01);中药结合手术组患者治疗前后患者症状体征评分比较,差异有统计学意义(P<0.01);3组患者治疗后评分进行以治疗方法作为因子的单因素方差分析,差异无统计学意义(P>0.05)。(3)乳房外形变化情况手术组与中药组比较,差异有统计学意义(P<0.05);乳房外形变化情况中药组与中药结合手术组比较,差异有统计学意义(P<0.05);乳房外形变化情况手术组与中药结合手术组比较,差异无统计学意义(P>0.05)。结论:手术、中药、中药结合手术3种治疗方法治疗浆细胞性乳腺炎,在改善临床症状体征方面,效果相当,在对乳房外形变化情况影响方面中药治疗优于手术治疗及中药结合手术治疗。

Objective. Clinical data of 115 patients with plasma cell mastitis were analyzed retrospectively so as to compare clinical curative effect of operation, Chinese medicine therapy, and operation combined with Chinese medicine therapy. Methods： Collected complete medical records in outpatient service and hospitalized records of 115 patients with plasma cell mastitis in surgical department of Guanganmen hospital of China Academy of Chinese Medical Sciences from January 2013 to December 2015. Understood clinical characteristics and treatment condition, evaluated effect of treatment method on clinical effect, treatment time and shape of breast. Results. Among the 115 patients, 7 patients received operation, accounting for 6.1%; 89 patients were given Chinese medicine, accounting for 77.4%; 19 patients were given Chinese medicine combined with operation, accounting for 16.5%. Among the 7 patients which received operation, there were two patients received segmental excision, two patients received tylectomy and three patients received incision and drainage of pyogenic infection. Among the patients which were given Chinese medicine combined with operation, there were two patients received segmental excision, fine patients received tylectomy and eleven patients received incision and drainage of pyogenic infection. The 85 cases that cured completely were divided into three groups based on the received treatment method. There were significant difference in the three kinds of treatment methods and their treatment time （P 〈 0.05）. Compared score of symptoms and signs of the operation group before and after treatment, the difference was significant （P〈 0.01）; Compared score of symptoms and signs of Chinese medicine group and Chinese medicine combined with operation group before treatment with those after treatment respectively, the differences were significant （P 〈 0.01）; Scores of the three groups after treatment were analyzed from the perspective of treatment method by the means of one-way ANOVA, but there being no significant difference （P 〉 0.05）. Compared change of breast shape of the Chinese medicine group with that of the Chinese medicine combined with operation group, the difference was significant （P 〈0.05）; But the difference between the operation group and Chinese medicine combined with operation group has no significant （P〉 0.05）. Conclusion. The three kinds of treatment has equivalent efficacy on improve clinical symptoms and signs of patients with plasma cell mastitis, while efficacy of Chinese medicine is better than that of the operation and Chinese medicine combined with operation in its effect on change of breast shape.