迁延性乳腺炎的外科治疗

目的：探讨迁延性乳腺炎的外科治疗方式。方法收集2010年3月-2012年12月新疆医科大学第一附属医院乳腺外科收治的137例迁延性乳腺炎患者的病历及随访资料，根据不同分型分别采用脓肿切开引流术、乳房炎性肿块扩大切除术、瘘管切除术和病变导管切除术，分析不同手术治疗方式及效果。结果脓肿切开引流术58例，术后52例痊愈，6例复发；炎性肿块扩大切除术25例中术后23例痊愈，2例复发；隐匿型36例、瘘管切除术17例及单纯乳房切除术1例，术后均痊愈；术后随访6～12个月，总共8例复发，复发率5．84％，经相应治疗后均痊愈。结论对于迁延性乳腺炎的有效治疗手段是彻底清除坏死组织及病变导管，术中消毒残腔及切口可有效预防炎症复发，术后重视换药及彻底引流可促进恢复。

A study on the surgical treatment of protracted mastitis

Objective To study the surgical treatment of protracted mastitis.Methods The medical records of 137 cases with protracted mastitis from March 2010 to December 2012 in Department of Breast Surgery of the First Affiliated Hospital of XinJiang Medical University have been collected.The cases were calssi-fied according to the different surgical treaments of abscess incision drainage,inflammatory breast mass expanded resection,resection of invalid duct and fistula,and then the records were analyzed in terms of their the operations and results of operative treatment.Results All cases included There were 52 cases cured and 6 cases of recurrence in 58 cases under the treament of abscess incision drainage,23 cases cured and 2 cases of recurrence in 25 cases of lumpectomy,and all cured in 36 cases of excision of lesion of mam-mary duct and 17 cases of fistulectomy and a case of simple mastectomy.Within 6 to 12 months of follow-up,there were 8 cases of recuurrence and the recurrence rate is 5.84%.But all were recovered after conser-vative treatment.Conclusion The valid therapeutic method of protracted mastitis was to remove the nec-rotic tissue and the diseased mammary gland ducts as much as possible,and disinfect surgery incision dur-ing operation.Prompt dressing change and thorough drainage is very important in enhancing the speed of recovery after surgery.