李小龙等

[摘要] 目的 探讨自制矫正器微创治疗乳头凹陷防治哺乳期乳腺炎的临床应用价值。 方法 选择2010年1月～2013年11月于石家庄市第四医院及曲阳县中医院就诊的100例乳头凹陷患者，随机分为对照组和观察组，每组各50例。观察组采用自制矫正器微创治疗乳头凹陷，对照组采用乳头乳晕局部组织填充法矫正乳头凹陷。观察两组患者术后哺乳期乳腺炎及乳腺脓肿的发生率。 结果 观察组患者哺乳期乳腺炎及乳腺脓肿发生率（14%、10%）均低于对照组（32%、26%），差异均有统计学意义（P < 0.05）。 结论 自制矫正器微创矫正乳头凹陷可明显降低哺乳期乳腺炎及乳腺脓肿的发生率，提高了患者母乳喂养率。

[关键词] 自制矫正器；乳头凹陷；哺乳期乳腺炎

[中图分类号] R655.8 [文献标识码] A [文章编号] 1673-7210（2015）06（b）-0076-04

Effect of self-made appliance minimally invasive treatment in nipple retraction and its prevention effect in lactation mastitis

LI Xiaolong1 YAO Jingjuan2 WANG Quanle1 ZHAO Haijun1

1.Department of Breast， the Fourth Hospital of Shijiazhuang City， Hebei Province， Shijiazhuang 050011， China； 2.Department of Obstetrics and Gynecology， Traditional Chinese Medicine Hospital of Quyang County， Hebei Province， Quyang 073100， China

[Abstract] Objective To investigate the clinical application value of the self-made appliance minimally invasive corrected the inverted nipple and its prevention effect in mastitis in lactation. Methods 100 patients with the nipple inversion from January 2010 to November 2013 were treated by the self-made appliance and minimally invasive way in the Fourth Hospital of Shijiazhuang City and Traditional Chinese Medicine Hospital of Quyang County， and they were divided into the control group and study group randomly， with 50 cases in each group. The incidence of mastitis and the mammary abscess in lactation of two groups were compared. Results The incidence of the mastitis and mammary abscess of the study group were lower than those of the control group， the differences were statistically significant （P < 0.05）. Conclusion The self-made brace and minimally invasive way reduce the mastitis and the mammary abscess in lactation significantly， promotes the rate of breast feeding.

[Key words] Self-made trader； Nipple inversion； Lactation mastitis

乳头凹陷是指乳头部分或全部凹陷于乳晕之中，是一种常见的女性乳腺疾病[1]。临床将乳头凹陷分为3型[2]：Ⅰ型：乳头部分凹陷，乳头颈部存在，能轻易用手将凹陷的乳头挤出，挤出后乳头大小与常人相似。Ⅱ型：乳头全部凹陷在乳晕之中，但可用手挤出乳头，乳头较正常为小，大多没有乳头颈部。Ⅲ型：乳头全部埋在乳晕下，无法使凹陷乳头挤出。本组临床研究仅包括SaKai分型的Ⅱ型及Ⅲ型乳头凹陷。长期的乳头凹陷会压迫乳晕后的淋巴管，导致机体内淋巴回流障碍，胶原组织渗出。正常的乳头顶部分布着15～20根乳管的开口，乳管内分泌物可通过乳头溢出，Ⅱ型及Ⅲ型乳头凹陷导致了生理性的乳管内分泌物不能通过乳头排出，积存在乳管内，乳管呈现扩张状态，乳管周围出现大量浆细胞浸润，导致了浆细胞性乳腺炎。同时，由于乳头凹陷，乳头表面脱落的表皮细胞及乳晕分泌物不能及时清除而刺激乳头皮肤，引起乳头乳晕炎症。……