[1]张凯* 张凯和王佳为共同第一作者① 王佳②.微创旋切联合抗生素封闭灌洗治疗肉芽肿性乳腺炎[J].中国微创外科杂志,2022,01(3):228-231.
 Zhang Kai,Wang Jia..Treatment of Granulomatous Mastitis by Minimally Invasive Biopsy Technique of Mammotome and Close Washing With Antibiotics[J].Chinese Journal of Minimally Invasive Surgery,2022,01(3):228-231.
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微创旋切联合抗生素封闭灌洗治疗肉芽肿性乳腺炎()
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《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
01
期数:
2022年3期
页码:
228-231
栏目:
临床研究
出版日期:
2022-06-02

文章信息/Info

Title:
Treatment of Granulomatous Mastitis by Minimally Invasive Biopsy Technique of Mammotome and Close Washing With Antibiotics
作者:
张凯* 张凯和王佳为共同第一作者① 王佳②
①(北京市西城区展览路医院外科,北京100044)②(河北省保定市妇幼保健院外科,保定071000)
Author(s):
Zhang Kai① Wang Jia②.
①Department of Surgery, Zhanlanlu Hospital, Beijing 100044, China; ②Department of Surgery, Baoding Maternal and Child Health Hospital, Baoding 071000, China
关键词:
麦默通系统灌洗肉芽肿 乳腺炎
Keywords:
Mammotome systemLavageGranulomatousMastitis
文献标志码:
A
摘要:
目的探讨微创旋切技术联合抗生素局部封闭灌洗治疗肉芽肿性乳腺炎的效果。方法2019年1月~2021年6月,对25例肉芽肿性乳腺炎行Mammotome微创旋切手术,旋切针道间隔0.5~0.8 cm,垂直交叉“网格状”切除肿块区域腺体以利充分引流。术后用含头孢呋辛和替硝唑的灌洗液局部封闭灌洗6~9 d。术后每3个月复诊,经临床查体配合超声检查观察疗效。结果25例均经病理确诊,抗酸染色阴性。未发生出血等严重并发症。治疗结束后炎症消退,肿块消失,伤口愈合,均治愈出院。中位住院时间15 d(11~22 d)。2例失访,23例有完整随访记录。中位随访8个月(3~28个月),仅1例术后18个月复发。按照肉芽肿性乳腺炎美学评估标准,患侧乳房外观评估优15例(65.2%),良7例(30.4%),差1例(43%)。优良率95.7%(22/23)。结论应用微创旋切联合抗生素局部封闭灌洗治疗肉芽肿性乳腺炎效果良好,具有恢复快、复发率低和对乳房外观影响小等优势。
Abstract:
ObjectiveTo explore the efficacy of treatment for granulomatous mastitis by using the minimally invasive biopsy technique of Mammotome system and close washing locally.MethodsTwentyfive patients with granulomatous mastitis was treated by using minimally invasive biopsy technique of Mammotome system combined with close washing locally from January 2019 to June 2021. The needle track interval of rotarycut was 0.5-0.8 cm. At same time, the mass area of the gland was given vertical cross “grid” resection to benefit fully drainage. After operation, the lavage liquid composed of cephalosporins and tinidazole was used for local close washing for 6-9 days. The followups were carried out every 3 months after operation, including clinical examination and ultrasonography.ResultsAll the patients were diagnosed by pathology, and the acidfast stain was negative. There was no serious complication such as bleeding during and after operation. After treatment, the inflammation subsided, the mass disappeared, and the wound healed. All the 25 patients were cured to discharge. Two cases were lost and 23 cases had complete followup records. After a median followup of 8 months (range, 3-28 months), only 1 case recurred 18 months after operation. According to the aesthetic evaluation standard of granulomatous mastitis, the appearance evaluation of the affected side of the breast was excellent in 15 cases (65.2%), good in 7 cases (30.4%) and poor in 1 case (4.3%). The excellent and good rate was 95.7% (22/23).ConclusionThe treatment of granulomatous mastitis by minimally invasive biopsy technique and close washing has the priority of fast recovery, low recurrence rate and little effect on the breast appearance.

参考文献/References:

[1]Aghajanzadeh M,Hassanzadeh R,Sefat SA,et al.Granulomatous mastitis:presentations,diagnosis,treatment and outcome in 206 patients from the north of Iran.Breast,2015,24(4):456-460.
[2]Benson JR,Dumitru D.Idiopathic granulomatous mastitis: presentation,investigation and management.Future Oncol,2016,12(11):1381-1394.
[3]Montazer M,Dadashzadeh M,Moosavi Toomatari SE.Comparison of the outcome of low dose and highdose corticosteroid in the treatment of idiopathic granulomatous mastitis.Asian Pac J Cancer Prev,2020,21(4):993-996.
[4]郑新宇,主译.乳腺良性病变与疾病.第1版.沈阳:辽宁科学技术出版社,2013.297.
[5]阚秀,丁华野,沈丹华,主编.乳腺治疗临床病理学.第1版.北京:北京大学医学出版社,2014.343-344.
[6]Liu PZ,Shi XG,Zuo XM,et al.A clinical study on the treatment of granulomatous lobular mastitis by the external application of the internal pusexpelling decoction and operation.Ann Palliat Med,2020,9(5):2631-2641.
[7]程涓,杜玉堂,丁华野.肉芽肿性小叶性乳腺炎的临床病理诊断及鉴别诊断.中华病理学杂志,2016,45(8):507-512.
[8]Uysal E,Soran A,Sezgin E,et al.Factors related to recurrence of idiopathic granulomatous mastitis:what do we learn from a multicenter study?ANZ J Surg,2018,88(6):635-639.
[9]于海静,王颀,杨剑敏,等.抗分枝杆菌药物治疗窦道型导管周围乳腺炎.中华外科杂志,2013,50(11):971-974.
[10]Ma X,Min X,Yao C.Different treatments for granulomatous lobular mastitis:a systematic review and metaanalysis.Breast Care (Basel),2020,15(1):60-66.
[11]续哲莉,边学海.Mammotome微创旋切系统在乳腺外科的应用(附132例分析).中国微创外科杂志,2005,5(9):754-756.
[12]王宁,陈平,刘军.乳房大体积肿物微创旋切的可行性研究.中国微创外科杂志,2020,20(11):1016-1018.

备注/Memo

备注/Memo:
*通讯作者,Email:zookoo0816@126.com ①(北京市西城区展览路医院外科,北京100044) ②(河北省保定市妇幼保健院外科,保定071000)
更新日期/Last Update: 2022-06-02