彩色多普勒超声实时引导下治疗哺乳期乳腺脓肿

Treatment of breast abscess in lactation with real-time guidance of color Doppler ultrasound

目的探讨在彩色多普勒超声实时引导下穿刺冲洗治疗哺乳期乳腺脓肿来替代传统的脓肿切开引流术的可行性及优缺点。方法选择2014年9月—2018年1月共60例哺乳期乳腺脓肿病例,在彩色多普勒超声定位引导下穿刺抽吸脓腔,并用含有庆大霉素的生理盐水溶液反复冲洗脓腔。结果共60例。共穿刺180例次,平均3次/例。穿刺治疗期间有5例出现乳汁漏出,未行特殊处理,2~3天后穿刺点完全愈合。15例经4次穿刺治疗痊愈,25例经5次穿刺治疗痊愈。11例穿刺6次后痊愈,7例经7次穿刺后痊愈。随访1个月至10个月,未发现脓肿复发病例,穿刺点周围无明显瘢痕形成,其中50例保留哺乳功能。治愈率达到100%。结论彩色多普勒超声实时引导下穿刺冲洗治疗哺乳期乳腺脓肿具有疼痛轻、创伤小,易操作、恢复快,不留瘢痕,不影响美观及保留哺乳功能的优点。

Objective:To investigate if ultrasound guided puncture can replace the traditional abscess incision drainage as the treatment of breast abscess.Methods select breast abscess treated with ultrasound-guided puncture from September 2014 to January 2015.Results Sixty cases underwent 180 times of puncture(means 3 times per case).Leakage occurred in 5cases after withdrawal of needles.The wound heal itself without special treatment after 2-3days.Fifteen cases were cured after 4 times of treatment.Twenty-five cases were cured after 5 times of treatment.Eleven cases were cured after 6 times of treatment.Seven cases were cured after 7 times of treatment.After follow-up for 1month to 10months.No recurrence or local scar was found.Fifty-five cases began breast feeding again after treatment.The cure rate was 100%.Conclusion:Ultrasound guided puncture for breast abscess is small trauma、safety real-time not affect the appearance and preserve lactation function.