紫色消肿膏外敷治疗产褥期乳腺炎的疗效观察

目的:探讨紫色消肿膏联合抗感染治疗产褥期乳腺炎的疗效。方法:将180例产褥期乳腺炎患者随机分为观察组和对照组各90例,观察组使用紫色消肿膏局部外敷,对照组用25%硫酸镁溶液局部热敷,两组均使用抗菌药物及对症治疗,3 d后进行疗效对比。结果:观察组总有效率、显效时间、疗程等优于对照组,差异具有统计学意义(P<0.01)。结论:紫色消肿膏外敷联合抗感染治疗产褥期乳腺炎疗效好。     

212例急性乳腺炎患者乳腺脓液细菌培养及药敏分析

目的：了解急性乳腺炎患者乳腺脓液标本中病原菌的分布及药物敏感性情况,为临床合理使用抗生素提供指导。方法：收集从乳腺炎患者乳腺脓肿中抽出的脓液标本经需氧培养分离后,再鉴定到种并用K-B法进行相应的药敏试验。结果：212份脓液标本分离出104株病原菌,分离率为49.1%,其中金黄色葡萄球菌93株,占89.4%;表皮葡萄球菌10株,占9.6%.草绿色链球菌1株,占1.0%。葡萄球菌对青霉素的耐药率为98.9%,对苯唑西林的敏感率为84.5%。对万古霉素的敏感率为100%,对环丙沙星、氧氟沙星、丁胺卡那的耐药率分别为18.4%、17.5%、14.6%,对头孢拉定（头孢一代）、西力欣（头孢二代）、头孢曲松（头孢三代）、头孢吡肟（头孢三代）的耐药率分别为33.0%、13.5%、11.7%、6.8%。对红霉素的耐药率高达80%以上,对复方新诺明和阿奇霉素的耐药率也在50%以上。结论：急性乳腺炎患者感染的主要病原菌为金黄色葡萄球菌,对青霉素、红霉素的耐药率较高,两者均不能作为治疗乳腺炎的首选药,而对耐青霉素酶的苯唑西林敏感率较高而且考虑乳腺炎患者大多处于哺乳期的用药安全,因此可用苯唑西林作为治疗大部分葡萄球菌引起的乳腺炎的首选药,但因为耐甲氧西林金黄色葡萄球菌（MRSA）的出现,且耐甲氧西林金黄色葡萄球菌（MRSA）的感染具有明显多重耐药性,所以临床医生必须重视治疗前标本的采集培养,根据药敏结果选用合理的抗生素。     

Granulomatous mastitis: An underdiagnosed inflammatory disease afflicting minority women

Granulomatous mastitis (GM) is an underdiagnosed and understudied benign inflammatory disease of the breast whose accurate diagnosis is confounded by mimicry of other breast pathologies (infectious mastitis and abscess, malignancy) and limited clinician knowledge of the disease. GM disproportionately affects minority women, furthering health disparities for a demographic already disadvantaged in the care of breast diseases. The first step in diagnosis is ultrasound followed by core needle biopsy yielding granulomatous inflammation. To far lesser degree, mammography, and MRI may play a role in narrowing the differential. A high index of clinical suspicion and multidisciplinary approach is required. The presence of Corynebacterium kroppensteddti may indicate one subtype of granulomatous mastitis called cystic neutrophilic granulomatous mastitis; disease stratification, and individualized therapy are on the horizon.