Wang Na, Hu Gang, Xu Lihua, Gong Lili, Wang Wanju
Department of Breast, Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science & Technology, Wuhan, China.
PLoS One. 2025 Jun 11;20(6):e0325739. doi: 10.1371/journal.pone.0325739. eCollection 2025.
To analyze the efficacy and safety of dexamethasone in the treatment of non-puerperal mastitis (NPM), providing a new idea for the treatment of NPM.
From August 1, 2017 to August 30, 2024, case data were collected from 552 patients with NPM. After grouping according to different treatment options, the SPSS statistical software was used for retrospective analysis of the collected data.
The number of days of drug treatment before operation in group B was less than other groups (p < 0.001). The group B had the most significant relief of pain symptoms and shorter time to complete relief of pain than other groups (p < 0.001). There were statistically significant differences between the 5 groups in the time required for pain to disappear and the time required for the volume to be reduced by half after treatment (p < 0.05).The overall efficacy evaluation had the highest effective rate in Group B (100%) and the lowest in Group D (2.10%), and the difference was statistically significant (p < 0.001).No side effects such as abnormalities in liver and kidney functions, water-electrolyte disorders, or peptic ulcers were observed in the five groups during drug treatment. There was no statistically significant difference in the occurrence of side effects such as rash, diarrhoea and hyperglycaemia among patients in the five groups (p > 0.05).The side effects of nausea (vomiting) and skin pigmentation in group E were higher than other groups(p < 0.001). In terms of weight gain (full moon face), nervous excitability (insomnia) and menstrual disorders, group B was lower than other groups (except group D without hormone therapy)(p < 0.001). In terms of postoperative recurrence after ipsilateral breast surgery, the recurrence rates of patients in group B were lower than those of the other four groups, and group D had the highest recurrence rate (8.30%), with a statistically significant difference (p < 0.001). Satisfaction survey found that group B had the highest satisfaction rate other groups (p < 0.05). The number of days required for the volume to be reduced by half after treatment was the most influential factor in the satisfaction survey. At the same time, we found that the obvious effect and recovery rate of GLM group was higher than that of PCM group, and the difference was statistically significant (p < 0.05).
Dexamethasone combined with levofloxacin/Metronidazole in the treatment of NPM has many advantages: first of all, it can significantly relieve the pain symptoms caused by the disease and effectively reduce the size of the lesion. Meanwhile, for the patients who plan to undergo surgery, the number of days of preoperative drug treatment can be reduced, and the overall effective rate is the highest. Secondly, the short-term application of drugs to treat side effects less, high safety; in the meantime, the risk of recurrence of the ipsilateral breast was less and the satisfaction of the patients was higher. The overall significant efficiency and recovery rate of GLM patients were higher than those of PCM patients.
分析地塞米松治疗非产褥期乳腺炎(NPM)的疗效及安全性,为NPM的治疗提供新思路。
收集2017年8月1日至2024年8月30日期间552例NPM患者的病例资料。根据不同治疗方案分组后,采用SPSS统计软件对收集的数据进行回顾性分析。
B组术前药物治疗天数少于其他组(p<0.001)。B组疼痛症状缓解最显著,疼痛完全缓解时间短于其他组(p<0.001)。5组在疼痛消失所需时间及治疗后肿块缩小一半所需时间上差异有统计学意义(p<0.05)。总体疗效评价中,B组有效率最高(100%),D组最低(2.10%),差异有统计学意义(p<0.001)。5组在药物治疗期间均未观察到肝肾功能异常、水电解质紊乱或消化性溃疡等副作用。5组患者皮疹、腹泻、高血糖等副作用发生率差异无统计学意义(p>0.05)。E组恶心(呕吐)和皮肤色素沉着副作用高于其他组(p<0.001)。在体重增加(满月脸)、神经兴奋性(失眠)和月经紊乱方面,B组低于其他组(D组无激素治疗除外)(p<0.001)。同侧乳腺手术后,B组患者复发率低于其他4组,D组复发率最高(8.30%),差异有统计学意义(p<0.001)。满意度调查发现,B组满意度高于其他组(p<0.05)。治疗后肿块缩小一半所需天数是满意度调查中最具影响力的因素。同时,我们发现肉芽肿性小叶性乳腺炎(GLM)组的显效及恢复率高于浆细胞性乳腺炎(PCM)组,差异有统计学意义(p<0.05)。
地塞米松联合左氧氟沙星/甲硝唑治疗NPM有诸多优势:首先,能显著缓解疾病所致疼痛症状,有效缩小病灶大小。同时,对于计划手术的患者,可减少术前药物治疗天数,总体有效率最高。其次,药物短期应用副作用少,安全性高;同时,同侧乳腺复发风险低,患者满意度高。GLM患者总体显效率及恢复率高于PCM患者。