乳管扩张冲洗联合乳腺疏通在治疗急性哺乳期乳腺炎中的应用

Application of breast duct expansion and irrigation combined with breast dredging therapy in the treatment of acute lactation mastitis

目的:探讨用乳管扩张器行乳管扩张冲洗联合手法乳腺疏通在急性哺乳期乳腺炎治疗中的应用。方法:回顾性分析首都医科大学附属北京潞河医院2017年7月至2018年6月收治的急性哺乳期乳腺炎患者106例。其中治疗组57例,采用乳管扩张冲洗联合手法乳腺疏通进行治疗;对照组49例,采用传统人工排乳及抗生素进行治疗。结果:治疗组抗生素使用率明显低于对照组,差异具有统计学意义(P<0.01);治疗组乳腺彩超低回声区的缩小程度明显高于对照组,差异存在统计学意义(P<0.05);治疗组与对照组的白细胞恢复情况对比无统计学差异(P>0.05),两组治疗效果相似。治疗组治疗过程中疼痛VAS评分为3.56±1.28。首次治疗前皮肤温度为(35.66±0.84)℃,治疗后为(34.11±1.01)℃,下降约(1.55±0.80)℃。结论:单用乳管扩张器进行乳管扩张冲洗配合乳腺疏通,可以有效治疗乳管堵塞,减轻炎症反应,缓解疼痛不适,减少全身抗生素应用及暂停哺乳,维持了泌乳,极大地减少了母婴及家庭身心和经济负担,且操作简单,值得推广。

Objective: To investigate the treatment effect of breast duct expansion and irrigation using breast duct dilator combined with manual mammary dredge in acute lactation mastitis. Methods: From July 2017 to June 2018, 106 patients with acute lactation mastitis in Beijing Luhe Hospital affiliated to Capital Medical University were analyzed. In the treatment group, 57 patients were treated with mammary duct dilatation and flushing combined with manual breast dredge;49 patients in the control group were treated with traditional artificial milk and antibiotics. Results: The usage of antibiotic in the treatment group was significantly lower than that in the control group (P<0.01). The reduction degree in the hypoechoic area of the ultrasound was significantly higher in the treatment group than in the control group (P<0.05). There was no significant difference in leukocyte recovery between the treatment group and the control group (P>0.05). The pain VAS score of the treatment group was 3.56±1.28. In the treatment group, the skin temperature before the first therapy was (35.66±0.84)℃ and after that was (34.11±1.01)℃, with an decrease about (1.55±0.80)℃. Conclusion: Breast duct dilator combined with flushing and breast dredge can effectively reduce inflammation, relieve pain, decrease systemic antibiotic application and breastfeeding suspension, and family’s mental and economic burden, which is simple and worth promoting.