清消法配合小切口病灶切除缝合术治疗肉芽肿性小叶性乳腺炎的临床研究

Clinical effect of cleaning method combined with small incision lesion resection on granulomatous lobular mastitis

目的观察清消法联合小切口病灶切除缝合术治疗肉芽肿性小叶性乳腺炎(GLM)的临床疗效。方法采用回顾性队列研究,从数据库抽2019年7月至2021年9月确诊为GLM且治疗期间均采用清消法治疗患者123例,以小切口病灶切除缝合术为暴露因素,选出暴露组(清消法联合小切口病灶切除缝合术)61例,非暴露组(单纯清消法治疗组)62例。比较2组治疗3、6、9个月治愈率、临床痊愈时间、治疗后乳房外形评价情况,并进行安全性评价。结果3个月时,暴露组治愈率26.2%(16/61),非暴露组治愈率1.6%(1/62),暴露组3个月时治愈率优于非暴露组(P<0.05)。6个月时,暴露组治愈率50.8%(31/61),非暴露组治愈率19.4%(12/62),暴露组6个月治愈率优于非暴露组(P<0.05)。9个月时,暴露组治愈率82.0%(50/61),非暴露组治愈率58.1%(36/62),暴露组9个月治愈率优于非暴露组(P<0.05)。暴露组临床痊愈时间短于非暴露组(P<0.05)。暴露组乳房外形优良率86.89%(53/61),非暴露组优良率70.97%(44/62),暴露组治疗后乳房外形优良率高于非暴露组(P<0.05)。2组治疗期间肝、肾功能均未见异常情况。结论清消法联合小切口病灶切除缝合术可以短期内提高GLM的治愈率,缩短临床痊愈时间,减少患者换药的痛苦,还能保持良好的乳房外观。

Objective To observe the clinical effect of cleaning method combined with small incision lesion resection on granulomatous lobular mastitis(GLM).Methods A retrospective cohort study included 123 GLM patients who were treated with clearing method from July 2019 to September 2021.Patients were receive cleaning method combined with small incision lesion resection(the exposure group,n=61)or simple cleaning method(the non-exposure group,n=62).The cure rate,clinical cure time,evaluation of breast shape,and safety evaluation on months 3,6,9 were included as comparators.Results The cure rate in the exposure group was better than that in the non-exposure group on months 3,6 and 9(26.2%[16/61]vs 1.6%[1/62]for month 3;50.8%[31/61]vs 19.4%[12/62]for month 6,82.0%[50/61]vs 58.1%[36/62]for month9;all P<0.05,respectively).The clinical cure time in the exposure group was shorter than that in the non-exposure group(P<0.05).The superior rate of breast shape was significantly higher than that in the non-exposure group(86.89%[53/61]vs 70.97%[44/62],P<0.05).There were no significant differences in liver and kidney function between groups during the treatment.Conclusion For GLM patients,cleaning method combined with small incision lesion resection can improve the cure rate in a short time,shorten the clinical cure time,reduce the pain of dressing change,with a good breast shape.