糖皮质激素与手术治疗在肉芽肿性乳腺炎患者中的应用

Application of glucocorticoids and surgical treatment in patients with granulomatous mastitis

目的:分析糖皮质激素与手术治疗在肉芽肿性乳腺炎患者中的应用效果。方法:选择2018年1月至2019年6月广西钦州市妇幼保健院医院乳腺外科收治的110例肉芽肿性乳腺炎患者,患者分组采用单双号法进行,单号为对照组,55例,采用手术治疗,双号为研究组,55例,采用糖皮质激素联合手术治疗,对比两组患者治疗前后的C反应蛋白(CRP)、白介素2(IL-2)等炎症因子水平、乳腺肿块最大直径、疼痛评分、治疗总有效率、乳房美容效果优良率、复发率。结果:CRP、IL-2等炎症因子水平、乳腺肿块最大直径、疼痛评分对比,治疗前两组间比较差异无统计学意义(P>0.05),治疗后,研究组显著低于对照组(P<0.05);治疗总有效率、乳房美容效果优良率对比,研究组显著高于对照组(P<0.05);复发率对比,研究组显著低于对照组(P<0.05)。结论:相比于单纯的手术治疗,采用糖皮质激素联合手术治疗肉芽肿性乳腺炎的临床效果更佳,不仅能有效减轻患者机体炎症因子水平和缓解其手术疼痛,同时还能提高患者乳房美容效果和降低其疾病复发率,从而能全面提高其预后质量。

Objective:To analyze the effect of glucocorticoids and surgical treatment in patients with granulomatous mastitis.Methods:110 patients with granulomatous mastitis thattreated in the Department of Breast Surgery of Qinzhou Maternal and Child Health Care Hospital from January 2018 to June 2019 were selected as research subjects.The patients weregrouped by odd and evennumber method,patientsof odd numberasthe control group(n=55)and were received surgical treatment,while patients of even numbers as the study group(n=55)and were treated with glucocorticoid combined with surgical treatment.The levels of inflammatory factors(C-reactive protein,CRP;interleukin 2,IL-2),maximum diameter of breast lumps,pain score,total treatment efficiency,quality of breast cosmetic surgery,and recurrence rate before and after treatment were compared between the two groups.Results:There was no significant difference between the two groups before treatment in terms of the levels of CRP,IL-2,the maximum diameter of breast lumps,and pain scores(P>0.05),whilethose index weresignificantly lower in the study group than in the control group after treatment(P<0.05).The total efficacy and the quality of breast cosmetic surgery of the study group were significantly higher than those ofthe control group(P<0.05).The recurrence rate of the study group was significantly lower than that of the control group(P<0.05).Conclusion:Compared with simple surgical treatment,the clinical effect of glucocorticoid combined with surgery in the treatment of granulomatous mastitis is better,which can not only effectively reduce the level of inflammatory factors and relieve the surgical pain of patients,but also improve the beauty of patients’breasts and reduce the rate of disease recurrence,which can comprehensively improve the quality of prognosis.