摘要
目的观察超声定位下病灶精准切除+Ⅰ期微整形在肉芽肿性小叶性乳腺炎中的应用效果。方法回顾性分析2017年1月-2020年7月武汉大学中南医院收治的53例肉芽肿小叶性乳腺炎患者的临床病理资料。结合临床表现及超声检查结果将患者分为四种类型:Ⅰ型,单一肿块;Ⅱ型,单一象限不伴皮损或伴1处皮损;Ⅲ型,多象限不伴皮损或伴1处皮损Ⅳ型,多象限伴多处皮损。25例患者行病灶扩大切除术(对照组),28例患者行超声定位下病灶精准切除+Ⅰ期微整形(观察组)。对伴有结节性红斑和Ⅳ型的患者术前及术后给予抗生素+激素治疗1周,其他类型直接手术。结果随访所有患者1年,观察组28例伤口一期愈合,3例术后出现切口愈合不良(均为Ⅳ型患者),予冲洗、换药等处理后痊愈;对照组出现6例复发(术前均为Ⅱ型和Ⅳ型患者)。两组术后复发率差异有统计学意义(0比24%,χ^(2)=6.033,P=0.014)。超声定位下病灶精准切除+Ⅰ期微整形手术的美容效果优于传统病灶扩大切除术(93%比68%,χ^(2)=5.330,P=0.020)。结论超声定位下病灶精准切除+Ⅰ期微整形治疗肉芽肿性小叶性乳腺炎术后复发率低,可获得良好的美容效果。
Objective To observe the efeet of local excision under ultrasonography with immediate mammoplasty in granulomatous lobular mastitis.Methods Fifty-three patients with granulomatous lobular mastitis admitted from Jan 2017 to Jul 2020 were retrospectively analyzed.Combined with sonographic findings and clinical manifestations,patients were divided into four types:type Ⅰ,single mass;Type Ⅰ,single mass located in one quadrant with one or no skin lesion;Type Ⅰ,muli-quadrant involved with one or no skin lesion;Type Ⅳ,multiple abscesses with multiple lesions in the skin.Twenty-five patients underwent wide local excision(control group);Twenty-eight patients underwent local exeision under ultrasonography with immediate mammoplasty(experiment group).Patients with erythema nodosum or in type Ⅳ were given antibiotics and corticosteroid therapy preoperatively for 1 week and postoperatively for 5 days.The others went straight to surgery.Results All patients were followed up for 1 year.In the experiment group,28 patients had primary wound healing,and 3 patients had poor wound healing after operation(all were of type Ⅳ).The control group had 6 cases of recurrence(were of type Ⅱ and lype Ⅳ).There was signifieant dfference of the reeurrence rate between the two groups(0vs.24%,χ^(2)=6.033,P=0.014),and the aesthetie ffeet of loeal excision under ulrasonography with immediate mammoplasty was better than that of wide loeal excision(93%u8.68%,χ^(2)=5.330,P=0.020),Conclusion The recurrence rate of local excision under ultrasonography with immediate mammoplasty is low,and with a satisfactory cosmetie ffect.
作者
周瑞
兰柳逸
郑乐葳
冯秦玉
廖亦秦
袁芊芊
吴高松
Zhou Rui;Lan Liuyi;Zheng Lewei;Feng Qinyu;Liao Yiqin;Yuan Qianqian;Wu Gaosong(Department of Thyroid and Breast Surgery,Zhongnan Hospital of Wuhan University,Wuhan 430071,China)
出处
《中华普通外科杂志》
CSCD
北大核心
2021年第2期118-121,共4页
Chinese Journal of General Surgery
