乳管镜下浆细胞性乳管炎的分型及临床研究

目的探讨乳管内窥镜对诊断及治疗浆细胞性乳腺炎的临床价值。方法对250例乳头溢液患者行乳管内窥镜检查,对其中95例浆细胞性乳腺炎患者在乳管内窥镜下对乳管内病变的特点予以分析并加以分型研究。结果95例浆细胞性乳腺炎患者中,Ⅰ型患者21例(22．1％),Ⅱ型患者43例(45．3％),Ⅲ型患者18例(18．9％),Ⅳ型患者13例(13．7％)。非手术治疗83例,症状完全缓解45例,好转38例。手术治疗12例,均病理证实,其中5例伴有中、重度不典型增生。结论乳管内窥镜可以对浆细胞性乳腺炎患者做出明确的诊断,并可对病变乳管进行定位,提示手术指征,使绝大多数患者避免手术,对需要手术活检的患者可缩小手术范围,是临床上一种不可缺少的辅助诊断方法。

Classification and clinical study of plasma cell mastitis under breast duct endoscope

OBJECTIVE: To evaluate the clinical significance of breast duct endoscope for plasma cell mastitis. METHODS: Breast duct endoscope was performed on 250 patients with nipple discharge. The characters of 95 cases of plasma cell mastitis under the breast duct endoscope were analyzed and studied. RESULTS: Among the 95 cases with plasma cell mastitis, 21 were in type I, 43 in type II, 18 in type III and 13 in type IV. Eighty-three cases were treated with no-operation treatment, and 45 completely released, 38 partly released. There were 5 cases with middle to serious atypical hyperplasia in 12 cases treated with operation, that were all confirmed by pathological examination. CONCLUSION: In patients with plasma cell mastitis, clear diagnosis can be made through breast duct endoscope, and the breast duct with lesions could be positioned. It is a necessary assistant method for patients to avoid biopsy or decrease the biopsy range.