48例肉芽肿性小叶性乳腺炎外科治疗体会

Observation for Surgical Treatments of 48 Cases of Granulomatous Lobular Mastitis

目的观察病灶扩大切除结合容积移位技术在肉芽肿性小叶性乳腺炎中的应用效果。方法回顾性分析2015年1月—2018年6月医院收治的48例肉芽肿性小叶性乳腺炎患者病例资料。结果所有患者均在术前予泼尼松治疗,病灶缩小或稳定后再予手术,22例患者接受了病灶扩大切除+容积移位手术,26例接受病灶扩大切除术。其中45例伤口一期愈合,3例术后出现切口愈合不良,予冲洗、换药等处理后痊愈,随访1年,4例出现复发,予再次病灶扩大切除后痊愈,两组间术后复发率差异无统计学意义(P>0.05),乳房扩大切除+容积移位手术的美容效果优于传统病灶扩大切除术(P<0.05)。结论病灶扩大切除术结合容积转移技术术后复发率低,可获得良好的美容效果,可在临床中应用。

Objective To observe the application effect of focal enlargement resection combined with volume displacement technique in granulomatous lobular mastitis.Methods The data of 48 patients with granulomatous lobular mastitis admitted to our hospital from January 2015 to June 2018 were retrospectively analyzed.Results All patients were treated with prednison before surgery,and operations were performed after the focus were reduced or stabilized.22 patients received focal enlargement resection in combination of volume displacement surgery,and 26 patients received traditional focal enlargement resection only.Among them,45 cases had satisfactory wound healing,3 cases had poor wound healing after operation,and were subsequently cured after cleaning and dressing change.The follow-up period was 1 year,4 cases had relapse,and recovered after additional resection.There was no significant difference in postoperative recurrence rate between the two groups(P>0.05).The cosmetic effect of focal enlargement resection plus volume displacement surgery was better than that of traditional focal enlargement resection(P<0.05).Conclusion Focal enlargement resection combined with volume displacement surgery has low recurrence rate after operation.It has good cosmetic effect,which can be widely applied in clinical practice.