Ⅰ期腺体瓣转移乳房成形术治疗肉芽肿性乳腺炎临床体会

Clinical Experience of Treatment of Granulomatous Mastitis Using Glandular Flap Methods to Re-Establish Breast with One-Stage Operation

目的：探讨Ⅰ期腺体瓣转移乳房成形术治疗肉芽肿性乳腺炎的临床应用价值,为建立肉芽肿性乳腺炎优化治疗方案提供有益的探索。方法：回顾2014年1月—2015年12月本院乳腺科应用I期腺体瓣转移乳房成形术治疗76例肉芽肿性乳腺炎患者的临床资料,评估其治愈率、复发率、术后并发症及乳房美观效果。结果：76例患者治愈率为97.4%（74/76）,术后随访14~37个月,其中2例患者同侧乳房疾病复发,3例对侧乳房复发,总复发率6.6%,全组无严重并发症发生。术后乳房美观效果：优秀、良好73例（96.1%）,一般3例（3.9%）,修复后乳房形态自然对称,手感良好。结论：根据病灶范围、全身情况以及患者的意愿选择I期腺体瓣转移乳房成形术治疗肉芽肿性乳腺炎疗效满意,最大限度的保留乳房外形并缩短了病程,是一种简单易行、安全可靠的术式,具有较高的临床应用价值。

Objective： To investigate the value of clinical application of one-stage operation to re-establish breast with glandular flap methods in the treatment of granulomatous mastitis and offer the beneficial seeking for establishing therapeutic scheme.Methods： Seventy-six patients with GM operated with one-stage glandular flap surgery to re-establish the breast in our department were analyzed retrospectively from Jan. 2014 to Dec. 2015. Then we assessed the cure rate,recurrence,postoperative complications and effect on mammary contour. Results： All patients were followed up for 14-37 months after operation and the cure rate was 97. 4%（ 74/76）. Two cases occurred ipsilateral breast recurrence and 3 contralateral breast recurrence. The total relapse rate was 6. 6%. The operations were all successful without serious complications,and the evaluation of cosmetology impression after breast surgery was classify to be excellent and good 73 cases（ 96. 1%） and common 3 cases（ 3. 9%）. The repaired breasts were characterized in natural,symmetric shape and good hand-feeling. Conclusion： According to the extent of the lesion,general circumstance and patients’ willingness,the GM patients who choose one-stage operation of glandular flap to re-establish the breast achieved satisfactory effects,maximum mamma shape retention and short course of treatment. This procedure which is simple and safe has a great value of clinical application.