非哺乳期乳腺炎临床特征分析(1)
摘要：目的 探讨非哺乳期乳腺炎(NPM)的临床特征。方法 回顾性分析2015年1月～2018年1月我院乳腺外科收治的60例NPM患者的临床资料，总结其临床特点及转归情况。结果 本次研究共纳入60例符合标准的NPM患者，平均发病年龄(35.84±7.38)岁，平均BMI(24.52±4.01)kg/m2，平均初潮年龄(13.42±3.03)岁，平均生育次数(1.20±0.64)次，平均流产次数(0.82±0.10)次，其中左乳患病33例(55.00%)，右乳患病27例(45.00%)，肿块平均直径(4.54±3.82)cm。病理证实乳腺导管扩张症/导管周围乳腺炎48例(80.00%)，肉芽肿性小叶乳腺炎12例(20.00%)。临床随访时间为1年，初次发病接受手术治疗(局部扩大切除)38例，至随访结束均痊愈;非手术治疗22例，至随访结束，4例痊愈，15例肿块大小无进展(缩小或不变)，3例出现进展(其中2例出现窦道)。结论 在乳腺导管扩张症/导管周围乳腺炎病例中，治疗仍以外科手术为主。对于肉芽肿性小叶乳腺炎，推荐类固醇治疗为首选。当有类固醇禁忌症或类固醇治疗无效时，可考虑选择手术切除。
, 百拇医药
关键词：非哺乳期乳腺炎;临床特征;手术治疗
中图分类号：R655.8 文獻标识码：A DOI：10.3969/j.issn.1006-1959.2019.06.040
文章编号：1006-1959(2019)06-0128-02
Abstract：Objective To investigate the clinical features of non-lactating mastitis.Methods The clinical data of 60 patients with non-lactation mastitis admitted to our hospital from January 2015 to January 2018 were retrospectively analyzed. The clinical characteristics and outcomes were summarized.Results A total of 60 eligible NPM patients were included in the study. The mean age of onset was (35.84±7.38) years， mean BMI (24.52±4.01) kg/m2， mean menarche age (13.42±3.03) years，the average number of births (1.20±0.64) times， the average number of abortions (0.82±0.10) times， including 33 cases of left breast disease (55.00%)， 27 cases of right breast disease (45.00%)， average diameter of tumor (4.54±3.82) )cm. Pathology confirmed 48 cases (80.00%) of mammary duct dilatation/ductal mammary gland inflammation， and 12 cases (20.00%) of granulomatous lobular mastitis. The clinical follow-up time was 1 year， 38 cases of initial cerebral surgery (local enlarged resection)， and all the patients were cured by follow-up; 22 cases were treated without surgery， 4 cases were cured after the follow-up， and 15 cases had no progress in size (narrow or no change)， 3 cases showed progress (two of them had sinus).Conclusion In MDE/PDM cases， treatment is still predominantly surgical. For granulomatous lobular mastitis， steroid therapy is preferred. When steroid contraindications or steroid therapy are not effective， surgical resection may be considered.
, http://www.100md.com
Key words：Breast;Non-puerperal mastitis;Clinical characteristics;Surgical treatment
非哺乳期乳腺炎(non-puerperal mastitis，NPM)是指乳房发生与妊娠及哺乳无关的炎性病变。目前，NPM约占乳腺良性病变的4%～5%，但其发病率逐年在增加，特别是在发展中国家[1]。非哺乳期乳腺炎被细分为乳腺导管扩张症(mammary duct ectasia，MDE)/导管周围乳腺炎(periductal mastitis，PDM)或肉芽肿性小叶乳腺炎(granulomatous lobular mastitis，GLM)[2]。由于缺乏典型的临床体征和症状，NPM常常被忽视。这种疾病的病因尚不清楚，它可能伴或不伴有感染。感染性NPM大多数表现为脓肿，即在乳房的局部区域积聚脓液[3]。大多数NPM患者通常表现出单个或多个乳房肿块，没有任何其他炎症迹象。因这些症状很难与乳腺癌区分，所以患者很容易被误诊为炎性乳腺癌或浸润性癌[4]。目前NPM尚无统一和规范的治疗方案，本文回顾性分析我院2015年1月～2018年1月收治的60例NPM患者的临床资料，旨在为临床医生提供治疗参考依据。, 百拇医药(解龙 练孝春 韩涛)
, 百拇医药
关键词：非哺乳期乳腺炎;临床特征;手术治疗
中图分类号：R655.8 文獻标识码：A DOI：10.3969/j.issn.1006-1959.2019.06.040
文章编号：1006-1959(2019)06-0128-02
Abstract：Objective To investigate the clinical features of non-lactating mastitis.Methods The clinical data of 60 patients with non-lactation mastitis admitted to our hospital from January 2015 to January 2018 were retrospectively analyzed. The clinical characteristics and outcomes were summarized.Results A total of 60 eligible NPM patients were included in the study. The mean age of onset was (35.84±7.38) years， mean BMI (24.52±4.01) kg/m2， mean menarche age (13.42±3.03) years，the average number of births (1.20±0.64) times， the average number of abortions (0.82±0.10) times， including 33 cases of left breast disease (55.00%)， 27 cases of right breast disease (45.00%)， average diameter of tumor (4.54±3.82) )cm. Pathology confirmed 48 cases (80.00%) of mammary duct dilatation/ductal mammary gland inflammation， and 12 cases (20.00%) of granulomatous lobular mastitis. The clinical follow-up time was 1 year， 38 cases of initial cerebral surgery (local enlarged resection)， and all the patients were cured by follow-up; 22 cases were treated without surgery， 4 cases were cured after the follow-up， and 15 cases had no progress in size (narrow or no change)， 3 cases showed progress (two of them had sinus).Conclusion In MDE/PDM cases， treatment is still predominantly surgical. For granulomatous lobular mastitis， steroid therapy is preferred. When steroid contraindications or steroid therapy are not effective， surgical resection may be considered.
, http://www.100md.com
Key words：Breast;Non-puerperal mastitis;Clinical characteristics;Surgical treatment
非哺乳期乳腺炎(non-puerperal mastitis，NPM)是指乳房发生与妊娠及哺乳无关的炎性病变。目前，NPM约占乳腺良性病变的4%～5%，但其发病率逐年在增加，特别是在发展中国家[1]。非哺乳期乳腺炎被细分为乳腺导管扩张症(mammary duct ectasia，MDE)/导管周围乳腺炎(periductal mastitis，PDM)或肉芽肿性小叶乳腺炎(granulomatous lobular mastitis，GLM)[2]。由于缺乏典型的临床体征和症状，NPM常常被忽视。这种疾病的病因尚不清楚，它可能伴或不伴有感染。感染性NPM大多数表现为脓肿，即在乳房的局部区域积聚脓液[3]。大多数NPM患者通常表现出单个或多个乳房肿块，没有任何其他炎症迹象。因这些症状很难与乳腺癌区分，所以患者很容易被误诊为炎性乳腺癌或浸润性癌[4]。目前NPM尚无统一和规范的治疗方案，本文回顾性分析我院2015年1月～2018年1月收治的60例NPM患者的临床资料，旨在为临床医生提供治疗参考依据。, 百拇医药(解龙 练孝春 韩涛)