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持续术后负压冲洗辅助乳房成形术治疗慢性难治性浆细胞性乳腺炎

Continuous postoperative negative pressure irrigation assisted mammaplasty in treating chronic refractory plasma cell mastitis.

作者信息

Xu Hua, Jiang Yan, Liao Mingjuan, Li Dongliang, Zhu Chenfang

机构信息

Department of General Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Discipline Construction Research Center of China Hospital Development Institute, Shanghai Jiao Tong University, Shanghai, China.

Department of Thoracic Surgery, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China.

出版信息

Gland Surg. 2020 Dec;9(6):2071-2078. doi: 10.21037/gs-20-795.

Abstract

BACKGROUND

Chronic refractory plasma cell mastitis (CRPCM) is an aseptic inflammation of the breast with a chronic course of the disease, extended treatment cycle (months to years), with a high recurrence rate. The objective of this study was to evaluate the efficacy of continuous postoperative negative pressure irrigation assisted mammaplasty (CPNPIAM) in treating CRPCM.

METHODS

Between 2016 and 2018, 36 CRPCM patients receiving CPNPIAM were enrolled in this study. CPNPIAM mainly involved complete lesion removal, immediate breast mammaplasty, and continuous postoperative negative pressure irrigation. The age of the patients, local symptoms, history of treatment, the duration of the disease before surgery, hospitalization period, related risk factors, the success rate, the recurrence rate and patients' overall satisfaction ratings were analyzed in the article.

RESULTS

Patients were aged between 22 and 53 years (mean 34.64 years). All patients had a history of conservative treatment or simple drainage. Local symptoms included inflammatory mass (n=36, 100%), abscess (n=33, 92%), nipple discharge (n=7, 19%), inflammatory plaque (n=34, 94%), and sinus tract formation (n=19, 53%). The lesion sizes ranged from 3 to 10 cm (mean 5.13 cm) in diameter. The mean hospitalization period was 8.42 days. The success rate was 100% (36/36) and the recurrence rate was 0% (0/36) at a 3-month follow-up. The patients' overall satisfaction ratings were "very good" (n=22, 61%), "good" (n=12, 33%), and "moderate" (n=2, 6%) with no poor or unsatisfactory ratings.

CONCLUSIONS

CPNPIAM is an effective way of treating CRPCM, and showed a high success rate, a low recurrence rate, and high patient satisfaction.

摘要

背景

慢性难治性浆细胞性乳腺炎(CRPCM)是一种乳腺无菌性炎症,病程慢性,治疗周期长(数月至数年),复发率高。本研究的目的是评估术后持续负压冲洗辅助乳房整形术(CPNPIAM)治疗CRPCM的疗效。

方法

2016年至2018年,本研究纳入了36例接受CPNPIAM治疗的CRPCM患者。CPNPIAM主要包括病变彻底切除、即刻乳房整形及术后持续负压冲洗。本文分析了患者的年龄、局部症状、治疗史、术前病程、住院时间、相关危险因素、成功率、复发率及患者总体满意度评分。

结果

患者年龄在22至53岁之间(平均34.64岁)。所有患者均有保守治疗或单纯引流史。局部症状包括炎性肿块(n = 36,100%)、脓肿(n = 33,92%)、乳头溢液(n = 7,19%)、炎性斑块(n = 34,94%)及窦道形成(n = 19,53%)。病变直径范围为3至10 cm(平均5.13 cm)。平均住院时间为8.42天。3个月随访时成功率为100%(36/36),复发率为0%(0/36)。患者总体满意度评分为“非常满意”(n = 22,61%)、“满意”(n = 12,33%)、“一般”(n = 2,6%),无差评或不满意评价。

结论

CPNPIAM是治疗CRPCM的有效方法,成功率高、复发率低且患者满意度高。

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