Ming Jia, Meng Gang, Yuan Qiaoying, Zhong Ling, Tang Peng, Zhang Kongyong, Chen Qingqiu, Fan Linjun, Jiang Jun
Breast Disease Center, Southwest Hospital affiliated with The Third Military Medical University, Chongqing, China.
Am Surg. 2013 Jan;79(1):54-60.
The objective of this study was to investigate the clinical characteristics and surgical modality of plasma cell mastitis (PCM). A total of 93 breasts of 91 female patients with PCM from June 2003 to June 2010 (unilateral in 89 patients and bilateral in two patients) were investigated in this study. All breasts were divided into two groups: the direct excision group (DE group) received focused excision and nipple retraction correction; and the incision drainage group (ID group) received these procedures only in the event of failing at least two incision drainages. Clinical characteristics, extent of excision, and prognosis were compared between two groups. There were 53 breasts in the DE group and 40 breasts in the ID group. No significant differences were noted in the number of retracted nipples and abscesses in the first visit or extent of disease between two groups (P > 0.05). However, during surgery, 3.85 ± 0.97 abscesses per breast were detectable in the ID group, which was significantly higher than 1.21 ± 0.06 abscesses per breast in the DE group. The ID group had significantly higher inflammation and excised extent compared with the DE group (P < 0.05). Hospitalization time was 179.60 ± 14.8 days in the ID group, which was significantly higher than 22.49 ± 1.93 days in the DE group (P < 0.05). Bacterial culture was negative for pus of 39 nonrupturing abscesses. Congenital nipple retraction may be the primary cause of PCM. Early and complete focused excision and nipple retraction correction are effective treatment methods.
本研究的目的是探讨浆细胞性乳腺炎(PCM)的临床特征及手术方式。本研究纳入了2003年6月至2010年6月期间91例PCM女性患者的93个乳房(89例为单侧,2例为双侧)。所有乳房被分为两组:直接切除组(DE组)接受局部切除及乳头内陷矫正术;切开引流组(ID组)仅在至少两次切开引流失败时才接受这些操作。比较两组的临床特征、切除范围及预后。DE组有53个乳房,ID组有40个乳房。两组在首次就诊时乳头内陷和脓肿的数量或疾病范围方面无显著差异(P>0.05)。然而,在手术过程中,ID组每个乳房可检测到3.85±0.97个脓肿,显著高于DE组的每个乳房1.21±0.06个脓肿。与DE组相比,ID组的炎症和切除范围显著更高(P<0.05)。ID组的住院时间为179.60±14.8天,显著高于DE组的22.49±1.93天(P<0.05)。39个未破裂脓肿的脓液细菌培养为阴性。先天性乳头内陷可能是PCM的主要原因。早期完整的局部切除及乳头内陷矫正术是有效的治疗方法。