非哺乳期乳腺炎临床特征分析

目的 探讨非哺乳期乳腺炎（NPM）的临床特征。方法 回顾性分析2015年1月~2018年1月我院乳腺外科收治的60例NPM患者的临床资料，总结其临床特点及转归情况。结果 本次研究共纳入60例符合标准的NPM患者，平均发病年龄（35.84±7.38）岁，平均BMI（24.52±4.01）kg/m2，平均初潮年龄（13.42±3.03）岁，平均生育次数（1.20±0.64）次，平均流产次数（0.82±0.10）次，其中左乳患病33例（55.00%），右乳患病27例（45.00%），肿块平均直径（4.54±3.82）cm。病理证实乳腺导管扩张症/导管周围乳腺炎48例（80.00%），肉芽肿性小叶乳腺炎12例（20.00%）。临床随访时间为1年，初次发病接受手术治疗（局部扩大切除）38例，至随访结束均痊愈；非手术治疗22例，至随访结束，4例痊愈，15例肿块大小无进展（缩小或不变），3例出现进展（其中2例出现窦道）。结论 在乳腺导管扩张症/导管周围乳腺炎病例中，治疗仍以外科手术为主。对于肉芽肿性小叶乳腺炎，推荐类固醇治疗为首选。当有类固醇禁忌症或类固醇治疗无效时，可考虑选择手术切除。

Analysis of Clinical Features of Non-lactating Mastitis

Objective To investigate the clinical features of non-lactating mastitis.Methods The clinical data of 60 patients with non-lactation mastitis admitted to our hospital from January 2015 to January 2018 were retrospectively analyzed. The clinical characteristics and outcomes were summarized.Results A total of 60 eligible NPM patients were included in the study. The mean age of onset was (35.84±7.38) years, mean BMI (24.52±4.01) kg/m2, mean menarche age (13.42±3.03) years,the average number of births (1.20±0.64) times, the average number of abortions (0.82±0.10) times, including 33 cases of left breast disease (55.00%), 27 cases of right breast disease (45.00%), average diameter of tumor (4.54±3.82) )cm. Pathology confirmed 48 cases (80.00%) of mammary duct dilatation/ductal mammary gland inflammation, and 12 cases (20.00%) of granulomatous lobular mastitis. The clinical follow-up time was 1 year, 38 cases of initial cerebral surgery (local enlarged resection), and all the patients were cured by follow-up; 22 cases were treated without surgery, 4 cases were cured after the follow-up, and 15 cases had no progress in size (narrow or no change), 3 cases showed progress (two of them had sinus).Conclusion In MDE/PDM cases, treatment is still predominantly surgical. For granulomatous lobular mastitis, steroid therapy is preferred. When steroid contraindications or steroid therapy are not effective, surgical resection may be considered.