改良后手术治疗乳腺脓肿效果观察及对炎性反应和疼痛因子影响

Efficacy of modified surgery in the treatment of breast abscess and its effects on inflammatory reaction and pain-related factors

目的探讨改良后手术治疗乳腺脓肿的效果及对炎性反应和疼痛因子的影响。方法选取舟山市妇女儿童医院2019年12月至2022年10月收治的乳腺脓肿患者100例,以随机数字表法分为观察组与对照组,每组50例。对照组行真空辅助旋切手术治疗,观察组行改良后手术治疗。记录两组手术情况,术后并发症和术后情况;比较两组术前和术后24 h炎性反应和疼痛因子变化。结果两组手术时间比较,差异无统计学意义(P>0.05);观察组术中出血量[(23.14±4.53)mL]显著少于对照组[(36.52±7.18)mL](t=11.14,P<0.001)。观察组并发症发生率[6.00%(3/50)]显著低于对照组[20%(10/50)](χ^(2)=4.33,P<0.05)。观察组术后24 h视觉模拟评分法(VAS)评分[(2.42±0.78)分]、换药次数[(5.26±1.34)次]、瘢痕程度[(6.82±1.27)mm]均显著低于对照组[(3.56±0.89)分、(7.43±1.62)次、(9.12±1.54)mm](t=6.81、7.30、8.15,均P<0.001)。观察组术后24 h超敏C反应蛋白(hs-CRP)[(14.52±3.37)mg/L]、白细胞介素1β(IL-1β)[(182.13±23.32)ng/L]、肿瘤坏死因子α(TNF-α)[(20.08±2.89)ng/L]均显著低于对照组[(29.94±5.45)mg/L、(231.24±16.56)ng/L和(29.98±4.36)ng/L](t=17.02、12.14、13.38,均P<0.001)。观察组术后24 h患者前列腺素E2(PGE2)[(97.14±18.78)ng/L]和P物质(SP)[(175.18±24.37)μg/L]水平均显著低于对照组[(148.65±20.06)ng/L和(265.41±27.86)μg/L](t=13.26、17.24,均P<0.001)。结论乳腺脓肿患者采用改良后手术治疗效果显著,并发症少,且对炎性反应影响小,可抑制疼痛因子释放。

Objective To investigate the efficacy of modified surgery in the treatment of breast abscess and its effects on inflammatory reaction and pain-related factors.Methods A total of 100 patients with breast abscess who were treated in Zhoushan Women and Children's Hospital from December 2019 to October 2022 were included in this study.They were divided into an observation group and a control group(n=50 per group)using the random number table.The control group received vacuum assisted rotary resection,while the observation group underwent modified surgery.Operation conditions,postoperative complications,and postoperative conditions were recorded in each group.Before and 24 hours after surgery,inflammatory reaction and pain-related factors were compared between the two groups.Results There was no significant difference in operative time between the two groups(P>0.05).The intraoperative bleeding volume in the observation group was(23.14±4.53)mL,which was significantly lower than(36.52±7.18)mL in the control group(t=11.14,P<0.001).The incidence of complications in the observation group was 6.00%(3/50),which was significantly lower than 20%(10/50)in the control group(χ^(2)=4.33,P<0.05).The observation group had significantly lower postoperative visual analogue scale score[(2.42±0.78)points],fewer dressing changes[(5.26±1.34)times],and lower scar degree[(6.82±1.27)mm]compared with the control group[(3.56±0.89)points,(7.43±1.62)times,(9.12±1.54)mm,t=6.81,7.30,8.15,all P<0.001].At 24 hours after surgery,high-sensitivity C-reactive protein,interleukin-1β,and tumor necrosis factor-αin the observation group were(14.52±3.37)mg/L,(182.13±23.32)ng/L,and(20.08±2.89)ng/L,respectively,which were significantly lower than(29.94±5.45)mg/L,(231.24±16.56)ng/L,and(29.98±4.36)ng/L in the control group(t=17.02,12.14,13.38,all P<0.001).At 24 hours after surgery,prostaglandin E2 and substance P in the observation group were(97.14±18.78)ng/L and(175.18±24.37)μg/L respectively,which were significantly lower than(148.65±20.06)ng/L and(265.41±27.86)μg/L in the control group(t=13.26,17.24,both P<0.001).Conclusion The modified surgical treatment for breast abscess shows significant effects with fewer complications and minimal impact on inflammatory response,effectively inhibiting the release of pain-related factors.