摘要
目的总结肉芽肿性乳腺炎(GM)的临床特征,为GM的诊断和早期治疗提供帮助。方法选取2013年12月—2015年3月北京市海淀妇幼保健院确诊为GM伴脓肿形成的患者44例为研究对象,对其一般资料(包括年龄、病程、哺乳史、用药史及相关疾病病史等)、临床表现、乳腺超声检查、实验室检查〔细菌培养、药敏试验、结核分枝杆菌基因检测〕、病理学检查、治疗及预后进行回顾性分析。结果 44例患者超声引导下空芯针穿刺病理学检查确诊,平均年龄(30.9±4.1)岁,病程2 d^12个月,88.6%(39/44)的患者有哺乳史。患者均因乳房肿块伴红肿、疼痛就诊,且均为单侧乳房病变,23例(52.3%)患者患侧先天性乳头凹陷。8例(18.2%)患者伴皮肤破溃,8例(18.2%)患者伴乳头溢液。乳腺超声检查示不规则混合回声或低回声,边界模糊,内部回声不均匀,加压其内可见液体流动。细菌培养阴性32例(72.7%),阳性12例(27.3%),其中9例为棒状杆菌阳性。随访6个月,其中36例(81.8%)患者痊愈,5例(11.4%)患者复发,3例(6.8%)患者失访。结论 GM好发于育龄期女性,临床表现以单侧乳房疼痛性肿块为主,局部皮肤红肿,脓肿型GM患者建议进行细菌培养及药敏试验以帮助医生选择最佳抗生素治疗,同时可行超声引导下脓肿穿刺并配合类固醇激素治疗。
Objective To summarize the clinical features of granulomatous mastitis（GM）,in order to facilitate the diagnosis and early treatment of GM. Methods From December 2013 to March 2015,we enrolled 44 patients with GM and abscess from Beijing Haidian Maternal ＆amp; Child Health Hospital as research subjects. A retrospective study was made on general data（ including age, course of disease, lactation history, medication history and related medical history ）, clinical performance,breast ultrasonic findings, laboratory examination （ bacterial culture, susceptibility test and PCR ）, histopathological features,treatment and prognosis. Results 44 patients were definitely diagnosed by pathological examination through tubular needle puncture with the guidance of color doppler ultrasound. The patients were averagely aged（30. 9 ± 4. 1）, with a disease course as long as 2 days to 12 months,and 88. 6% （39 / 44）patients had lactation history. The patients sought for treatment manly for lumps,being red and swollen,and pain in breasts,and all of them had lesion in one breast. 23（52. 3% ） patients had congenital nipple retraction on the lesion side,8（18. 2% ）patients had ulceration,and 8（18. 2% ）patients had nipple discharge. Color ultrasonography showed irregular mixed echo or hypo echo,vague boundary,nonuniform internal echo, and internal liquid flow when pressed. In bacterial culture,32（72. 7% ）patients had negative results,12（27. 3% ）patients had positive results,and 9 patients had corynebacterium positive. The patients followed up for 6 months,36（81. 8% ）patients were cured,5（11. 4% ）patients relapsed,and 3（6. 8% ）patients were lost to follow up. Conclusion GM is mostly seen in females at reproductive age. The usual symptoms include unilateral painful breast lump and erythema in local skin. Bacterial culture and susceptibility test are important to help doctors choose the best antibiotic therapy combining puncture guided by ultrasound and steroid hormones.
出处
《中国全科医学》
CAS
CSCD
北大核心
2016年第18期2216-2218,共3页
Chinese General Practice
关键词
肉芽肿性乳腺炎
脓肿
疾病特征
Granulomatous mastitis
Abscess
Disease attributes
