摘要
目的总结分析非哺乳期乳腺外周慢性炎症的临床特点,提高对该病的诊治水平。方法回顾性分析2006年1月至2009年12月期间收治的35例非哺乳期乳腺外周慢性炎症患者的临床资料。结果 35例患者无明显发热和局部乳房红肿表现,术前15例诊断为乳腺癌,20例乳腺癌未排除,伴乳房疼痛20例,合并免疫功能下降13例。17例既往有哺乳期乳腺炎病史,与其他患者相比,此组患者年龄较轻,多伴有疼痛症状,较少合并免疫功能低下。14例行空芯针穿刺,12例确定为慢性炎症。27例患者行手术治疗,病理诊断为乳腺慢性炎症、乳腺组织坏死并慢性炎症、肉芽肿性乳腺炎和浆细胞性乳腺炎。手术方法包括病灶完整切除,创面开放引流或置管冲洗,患者均痊愈。结论外周非哺乳期乳腺慢性炎症易与乳腺癌混淆,空芯针穿刺活检是确诊本病的有效手段。与传统术式比较,对有感染灶残留的病灶切除后置管冲洗引流可缩短病程。
Objective To summarize the clinical features of peripheral nonlactational chronic mastitis and improve the diagnosis and treatment. Methods Retrospectively analysis of elinicopathological data of 35 patients diagnosed as peripheral nonlactational chronic mastitis in the past four years. Results At admission 15 patients were diagnosed as breast cancer and 20 patients could not be ruled out the diagnosis of breast cancer. All patients had no fever and local reddening and swelling. There were 20 cases with breast pain and 13 cases with immunodeficiency. Patients with lactational mastitis history were younger, had higher incidence of breast pain, and lower incidence of immunodeficiency than those without. Core biopsy was done in 14 patients and 12 chronic mastitis were diagnosed. Twenty-seven patients underwent surgical treatment. Pathological diagnosis included chronic mastitis, necrotic lesion with chronic inffammation, granulomatous mastitis and plasma cell mastitis. Core biopsy was performed on 14 patients and 12 were chronic inflammation. Surgical treatments including completely resection, open drainage or tube drainage. All patients were cured after treatment. Conclusions Misdiagnosis of peripheral nonlactational chronic mastitis as breast cancer is common. Core biopsy is effective for pathological diagnosis. Chronic mastits is easy to relapse and surgical treatment is necessary. Compared with open drainage, the method of lumpectomy combined with irrigation and instillation of antibiotics can shorten course of disease.
出处
《中华普通外科学文献（电子版）》
2010年第6期16-19,共4页
Chinese Archives of General Surgery(Electronic Edition)
关键词
乳腺慢性炎症
乳腺癌
手术治疗
Nonlactational chronic mastitis
Breast cancer
Surgical treatment
