乳腺导管瘘的诊断和治疗

目的：探讨乳腺导管瘘的诊断和治疗方法。方法：诊断乳腺导管瘘23例主要依据病史、体征和病理切片。治疗是将与窦道相连的扩张导管切开达乳晕，彻底搔刮，去除炎性组织，完整切除瘘管，并充分引流，术后换药，通过肉芽生长使乳管瘘痊愈。结果：经过3－5周换药，所有的伤口均愈合，术后随访23例住院病人，无一例复发。结论：结合病史、体征易于诊断，疑难病例，特别是怀疑存在炎性乳癌的病人，应在术前做细针穿刺细胞学检查或在术中作冰冻病理检查。为了防止乳腺导管瘘复发，应切除瘘管及其近端乳管，必要时破坏乳头后方的所有乳腺导管，术后引流。

Diagnosis and treatment of mammary duct fistula

Objective To develop a rational and effective method for treatment of mammary duct fistula Methods 23 cases of mammary duct fistulae were reviewed Diagnosis were made depending on history,signs and pathological examination The involved lactiferous duct,the subareolar abscess,and part of the overlying nipple were incised and all the encompassing inflammatory tissues were excised Instead of primary suture of the wound, we open it for drainage and let it heal by granulation. Results After 3-5 weeks dressing exchange all wounds healed and in the follow-up of 23 patients,on recurrence was found. Concluions It is easy to diagnose when disease history and signs are obtained In case of difficult diagnosis,fine needle aspiration cytological examination is a choice. Frozen pathological examination is indicated when breast cancer is suspected during operation To prevent recurrence, the fistula with its proximal duct needs excision ,the nipple needs incision and the wound should be drained