洞穴式清创术与切开排脓术在亚急性期肉芽肿性乳腺炎患者中的应用效果比较

Comparison of the application effects of cave debridement and incision and drainage in patients with subacute granulomatous mastitis

目的比较洞穴式清创术与切开排脓术在亚急性期肉芽肿性乳腺炎患者中的应用效果。方法选择2019年1月至2021年8月我院收治的80例亚急性期肉芽肿性乳腺炎患者作为研究对象,依据入院编号的奇偶性将其分为观察组和对照组,各40例。观察组给予洞穴式清创术治疗,对照组给予切开排脓术治疗。比较两组的治疗效果。结果两组的治疗总有效率比较,差异无统计学意义(P>0.05)。治疗后3个月,观察组的乳房外形、乳房功能评分均高于对照组,差异具有统计学意义(P<0.05)。治疗后1个月,观察组的白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNFα)水平及白细胞分化抗原8阳性(CD8^(+))低于对照组,白细胞介素-10(IL-10)水平及白细胞分化抗原4阳性(CD4^(+))、CD4^(+)/CD8^(+)高于对照组,差异具有统计学意义(P<0.05)。治疗后1周、4周、2个月、3个月、6个月,观察组的疼痛数字评价量表(NTS)评分与C反应蛋白(CRP)水平均低于对照组,差异具有统计学意义(P<0.05)。结论洞穴式清创术与切开排脓术治疗亚急性期肉芽肿性乳腺炎患者的效果均较好,但前者可显著降低患者后续治疗中的疼痛感受、炎症反应,而且可提升乳腺美观度,其临床应用价值更高。

Objective To compare the application effects of cave debridement and incision and drainage in patients with subacute granulomatous mastitis.Methods A total of 80 patients with subacute granulomatous mastitis admitted in our hospital from January 2019 to August 2021 were selected as the research objects.According to the parity of admission number,the patients were divided into observation group and control group,with 40 cases in each group.The observation group was treated with cave debridement,and the control group was treated with incision and drainage.The therapeutic effects of the two groups were compared.Results There was no significant difference in the total effective rate of treatment between the two groups(P>0.05).At 3 months after treatment,the breast shape and breast function scores of the observation group were higher than those of the control group,and the differences were statistically significant(P<0.05).At 1 month after treatment,the levels of interleukin-6(IL-6),tumor necrosis factor-α(TNF-α)and cluster of differentiation 8 positive(CD8^(+))in the observation group were lower than those in the control group,the level of interleukin-10(IL-10),cluster of differentiation 4 positive(CD4^(+))and CD4^(+)/CD8^(+)were higher than those in the control group,and the differences were statistically significant(P<0.05).At 1,4 weeks,2,3 and 6 months after treatment,the Numerical Rating Scale(NTS)score and C-reactive protein(CRP)level in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).Conclusion Cave debridement and incision and drainage are effective in the treatment of patients with subacute granulomatous mastitis,but the former can significantly reduce the pain perception and inflammatory response in the follow-up treatment of patients,and improve the aesthetics of breast,which has higher clinical application value.