泌乳腺瘤的临床分析及文献复习

目的：探讨泌乳腺瘤的病因、临床表现及治疗方法。方法选择2004年7月1日至2012年3月30日于北京市海淀区妇幼保健院乳腺病防治中心确诊的泌乳腺瘤患者5例及于 Pubmed 数据库及万方数据库检索的1988年7月20日至2012年6月21日报道的6例泌乳腺瘤患者的临床病历资料为研究对象（本研究遵循的程序符合北京市海淀区妇幼保健院乳腺病防治中心人体试验委员会制定的伦理学标准,得到该委员会批准）。回顾性分析本组患者的病因、临床表现、治疗方法、疗效及预后;并对相关文献进行复习总结。结果本院收治的5例患者中,1例于孕龄为17孕周发现乳腺肿块,孕龄为25孕周时行乳腺肿物切除术,术后组织病理学检查结果示泌乳腺瘤;2例患者先行脓肿切开引流术后形成乳漏窦道,再次行肿物切除＋窦道切除术,术后愈合良好;1例于彩色多普勒超声引导下行4次乳房脓肿穿刺抽吸冲洗,感染控制后行乳房肿物切除术;1例行乳腺脓肿清创引流术时发现乳房内肿物予以切除。随访至今无一例患者复发。国外文献报道的3例患者均于妊娠期发病并接受手术治疗,国内文献报道的3例患者均于产后接受手术治疗。5例泌乳腺瘤患者行肿物切除术,1例泌乳腺瘤合并乳腺癌患者行乳腺癌改良根治术。术后均无一例患者复发。结论泌乳腺瘤是一种罕见的发生于围生期的良性肿瘤,过度按摩等干预易导致其感染。感染化脓后可采取超声引导下细针抽吸冲洗或切开引流治疗后,行肿物切除术根治。

Clinical Analysis of Lactating Adenoma and Related Literatures Review

Objective To investigate the etiology,clinical manifestations and treatment methods of lactating adenoma.Methods A total of 1 1 cases with lactating adenoma were included into this study. Among them,five cases were diagnosed as lactating adenoma in the Center for Prevention and Cure of Breast Disease,Beijing Haidian Maternal and Child Health Hospital From July 1,2004 to March 30,2012, another 6 cases of lactating adenoma were searched from Pubmed and Wanfang Database from July 20th, 1998 to June 21th,2012.This research followed the process conforms to the mammary gland disease prevention and control center of Beijing Haidian District Maternity and Child Care ethics standards promulgated by the human subj ects committee.Results Among those 5 cases,one case found breast lumps at gestational age of 17 weeks and underwent breast surgery for neoplasms at gestational age of 25 weeks. Postoperative histopathological examination results showed secrete breast tumor.Two patients underwent breast formed sinus tract and resected.One case was puctured 4 times guiding by the color Doppler ultra sound.After the infection was controlled,breast neoplasm was cutted off.One case was found breast neoplasm during the process of regular breast abscess drainage and underwent resection.The follow-up showed no one had recurrence.Among those 6 cases,three patients reported in literatures abroad showed patients accepted surgery during pregnancy,and another three patients reported in literatures in domestic showed patients underwent postpartum surgery treatment.And five cases underwent neoplasm resection and one case who was combined with breast cancer underwent breast cancer modified radical.No recurrence were found among those six patients.Conclusions Lactating adenoma is a rare benign tumor during perinatal period.Excessive intervention such as massage could lead to infection.Infections after maturation can be＆amp;nbsp;treated by the incision and drainage,or fine needle aspiration and flush with ultrasound-guided.