哺乳期乳腺炎的超声影像学特征及危险因素分析

Ultrasound imaging features and risk factors analysis of lactational mastitis

目的 探讨哺乳期乳腺炎的超声影像学特征及危险因素。方法 选取2019年5月—2022年5月河南省鹤壁市人民医院收治的60例哺乳期乳腺炎患者作为观察组研究对象,另选取同期于该院进行体检的60例哺乳期非乳腺炎健康产妇作为对照组研究对象。2组研究对象均行超声影像学检查。同时对比2组研究对象一般资料和哺乳情况,分析哺乳期乳腺炎发生的影响因素。结果 2组研究对象的乳腺肿块形态、边界及肿块血流信号分级情况比较,差异均有统计学意义(P<0.05)。2组研究对象妊娠次数、乳腺外伤情况、糖尿病史、生产方式、产后不良情绪发生情况、哺乳姿势、婴儿吸乳方式、每次哺乳时间、哺乳后乳头清洁频率、哺乳状况、非医务人员按摩情况、哺乳时长、吸奶器使用情况等比较,差异均有统计学意义(P<0.05)。Logistic回归分析结果显示:妊娠次数1次、有糖尿病史、剖宫产、产后有不良情绪、哺乳姿势为平躺、反复有乳汁淤积是哺乳期乳腺炎发生的危险因素(P<0.05),而每次哺乳前后清洁乳头、哺乳时间>6个月则是保护因素(P<0.05)。结论 哺乳期乳腺炎的超声影像学特征主要表现为肿块周围和内部呈点状散在血流信号,边界清,腺体内无回声或存在低回声团。妊娠次数为1次、有糖尿病史、剖宫产、产后有不良情绪、哺乳姿势为平躺、反复有乳汁淤积是哺乳期乳腺炎发生的危险因素,而哺乳前后清洁乳头、延长哺乳时间则可有效预防哺乳期乳腺炎的发生。

Objective This study aimed to investigate the ultrasound imaging features and risk factors of lactational mastitis.Methods A total of 60 lactational mastitis patients admitted to People's Hospital of Hebi from May 2019 to May 2022 were selected as the observation group;another 60 lactating healthy mothers without mastitis who underwent physical examination during the same period were selected as the control group.Ultrasound imaging was performed in both groups.The general information and lactation situation of the two groups were compared,and the influencing factors of lactational mastitis were analyzed.Results The morphology,boundary,and blood flow grading of breast masses in the two study groups were compared,and the differences were statistically significant(P<0.05).The comparison of the two study groups,including number of pregnancies,breast injury,history of diabetes,delivery mode,postpartum mood disorders,breastfeeding posture,baby suckling method,single breastfeeding duration,nipple cleaning frequency after breastfeeding,breastfeeding condition,non-medical staff massage,duration of breastfeeding,and use of breast pumps,showed statistically significant differences(P<0.05).Logistic regression analysis showed that primiparity,history of diabetes,cesarean section,postpartum mood disorders,lying flat while breastfeeding,and repeated galactostasis were risk factors for lactational mastitis(P<0.05),while nipple cleaning before and after breastfeeding and breastfeeding longer than 6 months were protective factors(P<0.05).Conclusion The ultrasound imaging features of lactational mastitis mainly show scattered blood flow signals in and around the mass,with clear boundaries and absence of or low echo masses in the gland.Primiparity,history of diabetes,cesarean section,postpartum mood disorders,lying flat while breastfeeding,and repeated galactostasis are risk factors for lactational mastitis,while nipple cleaning before and after breastfeeding and prolonged breastfeeding can effectively prevent the occurrence of lactational mastitis.