托里透脓外治法联合封闭负压引流治疗脓肿期肉芽肿性小叶性乳腺炎的临床研究

Clinical Study of Closed Negative Pressure Drainage Combined with Tori Sputum External Treatment for Granulomatous Lobular Mastitis in Abscess Stage

目的:探讨托里透脓外治法联合封闭负压引流(VSD)治疗脓肿期肉芽肿性小叶性乳腺炎(GLM)的临床治疗意义。方法:将40例入组患者分为VSD联合托里透脓外治法(观察组)和单用VSD治疗(对照组),观察组患者的住院时间、术后至切口愈合期间的换药次数、切口愈合时间、乳房疼痛情况、超声下脓肿范围变化、创面肉芽组织生长情况、切口纵径变化及治疗前后的血清IgG4^+、CD4^+、CD8^+、RF、C1q水平。结果:与对照组相比,VSD联合托里透脓外治法可明显减少住院时间,降低换药换药次数,缩短切口愈合时间,有效改善乳房疼痛,加速脓肿缩小,改善创面肉芽组织生长,加速切口纵径缩小,降低血清IgG4^+、CD4^+、CD8^+、C1q水平。差异有统计学意义(P<0.01)。结论:托里透脓外治法联合VSD治疗成脓期GLM疗效可靠,能明显缩短切口愈合时间,改善乳房炎症预后。

Objective To explore the clinical significance of Tori sputum external treatment combined with closed negative pressure drainage for the treatment of granulomatous lobular mastitis in abscess stage.Methods Forty patients enrolled were divided into VSD combined with Tori sputum external puncture(experimental group)and VSD alone(control group).The length of hospital stay,the number of dressings during postoperative incision healing and the time of wound healing were observed.Breast pain,changes in the extent of abscess under ultrasound,growth of granulation tissue in wounds,changes in longitudinal diameter of the incisionand changes in serum IgG4^+,CD4^+,CD8^+,RF and C1q before and after treatment were also observed.Results Compared with the control group,VSD combined with Tori pus external treatment can significantly reduce the length of hospital stay,reduce the number of dressing changes,shorten the time of wound healing,effectively improve breast pain,accelerate the reduction of abscess,improve the growth of wound granulation tissue and accelerate the incision.The longitudinal diameter reduced and serum IgG4^+,CD4^+,CD8^+and C1q values are lowered(P<0.01).Conclusion Tori's pus external treatment combined with VSD for the treatment of pus GLM is reliable,which can significantly shorten the incision healing time and improve the prognosis of breast inflammation.