摘要
目的分析肉芽肿性小叶性乳腺炎(IGM)在治愈后短期内(1年内)出现复发的临床特点和治疗方法。方法选取2017年1月~2018年6月在山西省长治市人民医院和山西大医院乳腺外科收治的70例经病理证实为IGM的患者为研究对象,其中42例采用联合治疗(药物+手术),28例采用单纯手术治疗。依照治愈后1年内患者是否出现复发分为复发组(14例)和无复发组(56例)。比较两组患者的临床特点和治疗方法。结果两组患者在体重指数、有无脓肿液、有无瘘管(窦道)方面比较,差异有统计学意义(P<0.05)。两组患者在年龄、哺乳时间、肿块大小方面比较,差异无统计学意义(P>0.05)。两组患者在治疗方式的选择上出现明显不同,联合治疗(药物+手术)可以明显减少复发情况的发生(P<0.05)。经多因素分析单纯手术和高体重指数值是引起复发的独立危险因素(P<0.05),接受单纯手术治疗的患者复发的风险是接受联合治疗患者的7.8倍,肥胖患者的复发的风险是其他患者的1.3倍。结论肥胖患者,有乳腺脓肿及瘘管(窦道)形成的患者,单纯手术治疗者具有较高的短期复发风险。而单纯手术治疗和肥胖是治愈后复发的独立危险因素。
Objective To analyze the clinical characteristics and treatment of idiopathic granulomatous mastitis(IGM)with recurrence in the short term(within 1 year)after cure.Methods Seventy patients with pathologically confirmed IGM admitted to the department of breast surgery of Changzhi People′s Hospital of Shanxi Province and Shanxi Dayi Hospital from January 2017 to June 2018 were selected as the study subjects,among which 42 cases were treated with combination therapy(drugs+surgery)and 28 cases were treated with surgical treatment alone.Patients were divided into the relapsing group(14 cases)and the non-relapsing group(56 cases)according to whether they had relapsed within 1 year of cure.The clinical characteristics and treatment methods of the two groups were compared.Results There were statistically significant differences in body mass index with or without abscess fluid and with or without fistula(sinus tract)between the two groups(P<0.05).There was no significant difference in age,lactation time and mass size between the two groups(P>0.05).After multi-factor analysis,surgery alone and high body mass index were independent risk factors for recurrence(P<0.05).The risk of recurrence in patients who received surgical treatment alone was 7.8 times higher than that in patients receiving combined treatment,and the risk of recurrence in obese patients was 1.3 times higher than that in other patients.Conclusion Patients with obesity,breast abscesses and fistula(sinus tract)formation,and surgical treatment alone have a higher risk of short-term recurrence.Surgical treatment alone and obesity are independent risk factors for recurrence after treatment.
作者
任云
徐建忠
杨海波
张晋丹
REN Yun;XU Jianzhong;YANG Haibo;ZHANG Jindan(Department of Breast Surgery,Changzhi People′s Hospital,Shanxi Province,Changzhi 046000,China;Department of Breast Surgery,Shanxi Dayi Hospital,Shanxi Province,Taiyuan 030000,China)
出处
《中国医药导报》
CAS
2020年第8期144-147,共4页
China Medical Herald
基金
山西省软科学研究计划项目(2018041032-2)。
关键词
肉芽肿性小叶性乳腺炎
手术
复发
危险因素
Idiopathic granulomatous mastitis
Surgery
Recurrence
Risk factors
