自体脂肪移植隆乳后非结核分枝杆菌感染的救治策略

Treatment Strategy of Non-tuberculous Mycobacterium Infection after Augmentation Mammaplasty with Autologous Fat Transplantation

目的:观察彻底清创联合药物治疗对自体脂肪移植隆乳后非结核分枝杆菌(Non-tuberculous mycobacterium,NTM)感染的治疗效果,探讨其有效的救治策略。方法:2018年4月-2020年12月医院收治10例自体脂肪移植隆乳后NTM感染患者,经小切口多次彻底清创、持续封闭负压吸引,静脉联合口服多种抗生素治疗。结果:7例患者经上述联合治疗,伤口愈合,乳房形态满意;1例患者多重药物过敏,经脱敏治疗后痊愈;2例患者后期病灶局限,经再次手术清创后痊愈。10例患者出院后随访1~2年,无复发,经微等离子射频治疗后,切口瘢痕得到进一步改善。结论:对自体脂肪移植隆乳后NTM感染患者,采用彻底手术清创联合药物治疗策略具有较好疗效,值得临床推广。

Objective To observe the effect of surgical debridement combined with drug therapy on non-tuberculous mycobacterium (NTM) infection after augmentation mammaplasty with autologous fat transplantation,and to explore its effective treatment strategy.Methods 10 patients with NTM infection after augmentation mammaplasty with autologous fat transplantation were admitted to our hospital from April 2018 to December 2020.They received complete debridement through small incisions,vacuum sealed drainage (VSD) and intravenous combined with oral multiple antibiotics.Results Seven patients who received the above combined treatment recovered and were satisfied with their breast shape.One patient was allergic to multiple drugs and recovered after desensitization treatment.Two patients had lesions limited and were ultimately cured after debridement again.The 10 patients were followed up for 1-2 years after discharge,and no recurrence occurred.After micro plasma radiofrequency therapy,the scar of the incision was further improved.Conclusion For patients with NTM infection after augmentation mammaplasty with autologous fat transplantation,the strategy of surgical debridement combined with drug therapy shows a good effect and is worthy of clinical promotion.