Thomsen A C, Espersen T, Maigaard S
Am J Obstet Gynecol. 1984 Jul 1;149(5):492-5. doi: 10.1016/0002-9378(84)90022-x.
In nursing women with inflammatory symptoms of the breast, it has been possible on the basis of leukocyte counts of the milk and quantitative cultivation for bacteria to classify these cases into milk stasis (counts of less than 10(6) leukocytes and less than 10(3) bacteria per milliliter of milk), noninfectious inflammation (counts of greater than 10(6) leukocytes and less than 10(3) bacteria), and infectious mastitis (counts of greater than 10(6) leukocytes and greater than 10(3) bacteria). In the present study the duration and outcome of these cases were observed, and those without intervention were compared to those with treatment that consisted of systematic and intensive emptying of the breast, supplemented in some cases by antibiotic therapy as directed by susceptibility tests of the bacteria. The course of milk stasis was of short duration and the outcome was good independent of treatment. In cases of noninfectious inflammation the symptoms persisted for several days without treatment, and half of the patients developed infectious mastitis. Emptying of the breast resulted in a significant decrease in the duration of symptoms and a significantly improved outcome. Infectious mastitis without treatment was followed by a good result in only 15% of the cases, and 11% developed abscesses. Emptying of the breast increased the rate of a good outcome to 50% and significantly decreased the duration of symptoms. The addition of antibiotic therapy resulted in a good outcome in 96% of the cases and a further significant reduction of the persistence of symptoms.
对于有乳房炎症症状的哺乳期妇女，根据乳汁中的白细胞计数和细菌定量培养，有可能将这些病例分为乳汁淤积（每毫升乳汁中白细胞计数少于10⁶且细菌少于10³）、非感染性炎症（白细胞计数大于10⁶且细菌少于10³）和感染性乳腺炎（白细胞计数大于10⁶且细菌大于10³）。在本研究中，观察了这些病例的病程和结局，并将未接受干预的病例与接受治疗的病例进行了比较，治疗包括有系统且充分地排空乳房，某些情况下根据细菌药敏试验指导加用抗生素治疗。乳汁淤积病程较短，无论是否治疗结局都较好。在非感染性炎症病例中，未经治疗症状会持续数天，且一半患者会发展为感染性乳腺炎。排空乳房可使症状持续时间显著缩短，结局明显改善。未经治疗的感染性乳腺炎仅有15%的病例结局良好，11%会形成脓肿。排空乳房使良好结局的比例增至50%，并显著缩短了症状持续时间。加用抗生素治疗使96%的病例结局良好，并进一步显著缩短了症状持续时间。
