Christensen A F, Al-Suliman N, Nielsen K R, Vejborg I, Severinsen N, Christensen H, Nielsen M B
Department of Radiology, Bispebjerg Hospital, University of Copenhagen, Denmark.
Br J Radiol. 2005 Mar;78(927):186-8. doi: 10.1259/bjr/26372381.
The aim of this paper is to describe the efficacy of ultrasound-guided drainage of breast abscesses with special attention to the risk of recurrence and the need for surgical treatment in a consecutive patient population. 151 patients, 89 with puerperal and 62 with non-puerperal breast abscesses, were treated with ultrasound-guided drainage, by needle or catheter under local anaesthesia. Follow-up punctures were performed at 2 or 3 day intervals until the clinical condition and ultrasound findings had improved. All patients were treated with oral antibiotics. Mammography was performed to search for underlying cancer. 86 (97%) out of 89 patients with puerperal abscesses and 50 (81%) out of 62 with non-puerperal abscesses recovered after the first round of ultrasound-guided drainage. One patient in each group had recurrence in loco but recovered after further ultrasound-guided drainage. 13 patients, 11 with non-puerperal and two with puerperal abscesses, underwent surgical excision of the abscess cavity or fistulas. Breastfeeding continued and 117 patients were treated as outpatients. The median number of follow up examinations in the ultrasound-department was four (range 1-10) for the group of patients with puerperal abscess and three (range 1-7) in the group of patients with non-puerperal abscess. The corresponding figure for the median number of punctures was for both groups one (range 1-6 and 1-4). There were no reports of newly diagnosed breast cancer in the 2 year follow-up period. This study supports the use of ultrasound-guided drainage in puerperal and non-puerperal breast abscesses. The method is less invasive than traditional surgery and has a high rate of success.
本文旨在描述超声引导下乳腺脓肿引流的疗效，特别关注连续患者群体中的复发风险及手术治疗需求。151例患者，89例为产后乳腺脓肿，62例为非产后乳腺脓肿，在局部麻醉下通过针或导管进行超声引导下引流。每隔2或3天进行随访穿刺，直至临床症状和超声检查结果改善。所有患者均接受口服抗生素治疗。进行乳腺钼靶检查以寻找潜在癌症。89例产后脓肿患者中有86例（97%）、62例非产后脓肿患者中有50例（81%）在第一轮超声引导下引流后康复。每组各有1例患者局部复发，但在进一步超声引导下引流后康复。13例患者，11例为非产后脓肿，2例为产后脓肿，接受了脓肿腔或瘘管的手术切除。母乳喂养得以继续，117例患者作为门诊患者接受治疗。产后脓肿患者组在超声科的中位随访检查次数为4次（范围1 - 10次），非产后脓肿患者组为3次（范围1 - 7次）。两组穿刺次数的相应中位数值均为1次（范围分别为1 - 6次和1 - 4次）。在2年随访期内未报告有新诊断的乳腺癌病例。本研究支持在产后和非产后乳腺脓肿中使用超声引导下引流。该方法比传统手术侵入性小，成功率高。
