乳房区域灌注技术在难治性肉芽肿性小叶性乳腺炎中应用价值

目的探讨乳房区域灌注技术在难治性肉芽肿性小叶性乳腺炎(RGLM)中应用价值。方法回顾性分析2020年6月至2021年6月乳房区域灌注技术137例难治性肉芽肿性小叶性乳腺炎的临床资料。结果137例患者单侧手术132例,同时双侧手术5例,单侧手术时间(30±5)min,术中出血量(60±18)mL;术后无乳头缺血坏死;RGLM伴随症状(乳房剧烈疼痛、四肢结节红斑、关节酸痛、发热、干咳和头痛等)均在1周内缓解;术后阳和汤内服(2.9±0.7)个月;平均随访时间23.5个月,复发率0.7%;9例意向母哺乳喂养6个月内均未并发哺乳期乳腺炎;乳房美容效果满意。结论乳房区域灌注技术治疗RGLM效果满意,值得临床推广。

Objective To investigate the clinical efficacy of breast regional perfusion operation for the treatment of refractory granulomatous lobular mastitis(RGLM).Methods A total of 137 patients with a histopathologically proven diagnosis of RGLM who received regional breast perfusion from June 2020 to June 2021 were retrospectively analyzed.Results Among 137 patients,132 underwent unilateral operation and 5 underwent bilateral operation simultaneously.The average unilateral operation time was(30±5)min,and the intraoperative bleeding loss was(60±18)mL.There were no ischemic necrosis nipple after surgery.The coexistence of RGLM,severe breast pain,erythema nodosum,arthritis,fever,dry cough,and headache resolved within 1 week.Patients were taken Yanghe decoction orally for(2.9±0.7)months after surgery.The average follow-up time was 23.5 months,and the recurrence rate was 0.7%.None of the 9 women who intended to breastfeed had lactation Mastitis within 6 months.All patients showed excellent results in the aesthetic evaluation of breast appearance.Conclusion Breast regional perfusion operation can safely and effectively treat RGLM,and the follow-up results show that the therapeutic effect has basically reached the expected goal.