摘要
目的探讨哺乳期乳腺炎导致乳腺脓肿的危险因素。方法回顾性分析2018年2月至2020年2月就诊于福建省妇幼保健院乳腺科的乳腺炎患者的病历资料,其中非脓肿性乳腺炎404例,乳腺脓肿患者128例。收集患者的年龄、发热病程、最高体温、积乳位置、抗生素使用等方面的基本资料。分别进行单因素分析和多因素回归分析。结果单因素及多因素分析结果显示,两组患者在发热病程、最高体温、乳头内陷乳腺既往手术/乳腺炎史、肿块位置方面的差异有统计学意义(P<0.05)。亚组分析结果显示,高体温亚组(>38.5℃)发现未使用抗生素、长发热病程(>2 d)、乳腺既往手术史/乳腺炎、积乳位置(乳头乳晕区)是乳腺脓肿的危险因素(OR=1.954、1.746、1.820、2.203)。低体温亚组(<38.5℃)中长发热病程(>2 d)、乳腺既往手术/乳腺炎史、乳头皲裂是乳腺脓肿的危险因素(OR=2.634、2.512、2.199)。各型乳头内陷的乳腺脓肿发生率分别为:无内陷20.52%、Ⅰ度15.00%、Ⅱ度38.46%、Ⅲ度57.14%,Ⅰ度、Ⅱ度、Ⅲ度内陷发生率相较于无乳头凹陷是脓肿的危险因素(OR=0.168、0.115、0.394);两两比较显示,Ⅱ度、Ⅲ度内陷发生率与无内陷、Ⅰ度内陷发生率比较,差异均有统计学意义(P<0.05)。结论乳头内陷、长发热病程(>2 d)、高体温(>38.5℃)、乳腺既往手术史/乳腺炎、肿块位置(乳头乳晕区)、Ⅱ度、Ⅲ度乳头内陷是导致乳腺脓肿的危险因素。
Objective To explore the risk factors of breast abscess caused by breast-feeding mastitis.Methods A retrospective analysis of the medical records of patients with mastitis in the department of breast,Fujian Maternal and Child Health Hospital from February 2018 to Febr uary 2020,included 404 cases of non-abscessive mastitis and 128 cases of breast abscess.Collect information on patients including age,fever course,maximum body temperature,location of breast accumulation,antibiotic use,etc.Single factor analysis and multi-factor analysis were performed respectively.Results Univari ate and multivariate analysis showed that the two groups of patients had statistical signifi cant diff erences in the course of fever,maximum body temperature,inverted nipples,previous breast surgery/mastitis history,and lump location(P<0.05).The result of subgroup analysis showed that no antibiotics,long course of fever(>2 days),previous breast surgery/mastitis,and lump location(nipple and areola area)were risk factors for breast abscess in the high body temperature subgroup(>38.5℃)(OR=1.9541.746,1.820,2.203).In the hypothermia subgroup(<38.5℃),the long-term fever(>2 days),previous breast surgery/mastitis history,and cracked nipple were risk factors(OR=2.634,2.512,2.199).The incidence rates of breast abscesses of various types of inverted nipple were:20.52%without inverted,15.00%withⅠdegree,38.46%withⅡdegree,57.14%withⅢdegree.Compared with non-inverted nipple,the incidence ofⅠdegree,Ⅱdegree andⅢdegree inverted nipple is a risk factor for abscess(OR=0.168,0.115,0.394).Pairwise comparisons show that the incidence ofⅡdegree andⅢdegree invagination is compared with the incidence of without inverted andⅠdegree invagination,and the diff erence is statistically signifi cant(P<0.05).Conclusion Inverted nipple and long-term fever(>2 days),high body temperature(>38.5℃),history of breast surgery/mastitis,lump location(nipple areola area),ⅡandⅢdegree inverted nipple are risk factors of breast abscess.
作者
吴剑斌
罗明敏
王红玫
陈壮威
WU Jianbin;LUO Mingmin;WANG Hongmei;CHEN Zhuangwei(Department of Breast,Fujian Maternal and Child Health Hospital,Fuzhou 350001,China;Department of Reproductive Center,Fujian Maternal and Child Health Hospital,Fuzhou 350001,China)
出处
《中国医药指南》
2020年第34期6-9,共4页
Guide of China Medicine
关键词
乳腺脓肿
哺乳期
乳腺炎
危险因素
Breast abscess
Lactation period
Mastitis
Risk factors
