王志超

【摘要】 目的：探討乳腺脓肿应用脓腔置管冲洗的临床效果。方法：选取2017年12月-2019年12月于本院治疗的86例哺乳期乳腺脓肿患者，根据治疗方式不同分为对照组和观察组，每组43例。对照组给予传统切开引流治疗，观察组采用脓腔置管冲洗治疗。比较两组HAMD、VAS、ADL评分和围手术期各项指标及预后情况。结果：治疗后2周，两组HAMD、VAS、ADL评分均优于治疗前，且观察组HAMD与VAS评分均低于对照组，ADL评分高于对照组（P<0.05）;观察组伤口愈合时间、切口长度及术中出血量均优于对照组（P<0.05）;观察组回乳、复发、伤口感染及伤口出血发生率均低于对照组，继续哺乳率和满意度均高于对照组（P<0.05）。结论：乳腺脓肿患者应用脓腔置管冲洗治疗可改善心理状态，减轻疼痛，提高日常生活能力，缩短伤口愈合时间，有助于继续哺乳，患者满意度较高，值得推广应用。

【关键词】 乳腺脓肿 脓腔置管冲洗

Clinical Effect of Abscess Cavity Catheterization Irrigation in Mammary Abscess/WANG Zhichao. //Medical Innovation of China， 2021， 18（14）： 0-067

[Abstract] Objective： To investigate the clinical effect of abscess cavity catheterization irrigation in mammary abscess. Method： A total of 86 patients with lactation mammary abscess treated in our hospital from December 2017 to December 2019 were selected. They were divided into control group and observation group according to different treatment methods， with 43 cases in each group. The control group was treated with traditional incision and drainage， and the observation group was treated with abscess cavity catheterization irrigation. HAMD， VAS， ADL scores， perioperative indexes and prognosis were compared between the two groups. Result： 2 weeks after treatment， HAMD， VAS and ADL scores in both groups were better than those before treatment， HAMD and VAS scores in the observation group were lower than those of the control group， and ADL scores in the observation group was higher than that of the control group （P<0.05）. Wound healing time， incision length and intraoperative blood loss in the observation group were better than those in control group （P<0.05）. The incidence of lactation， recurrence， wound infection and wound bleeding in the observation group were lower than those in the control group， and the rate of continuous lactation and satisfactory in the observation group were higher than those in the control group （P<0.05）. Conclusion： Abscess cavity catheterization irrigation treatment for patients with mammary abscess can improve their psychological state， relieve pain， improve their daily living ability， shorten the time of wound healing， and help to continue breastfeeding， therefore， the satisfaction of patients is high， and it is worthy of popularization and application.

[Key words] Mammary abscess Abscess cavity catheterization irrigation

First-authors address： Jiamusi Maternal and Child Health Hospital， Jiamusi 154002， China

doi：10.3969/j.issn.1674-4985.2021.14.016

乳腺脓肿是哺乳女性常见疾病，属于慢性乳腺炎并发症之一，具有较高的发病率，主要病因是乳头皲裂、畸形以及乳汁淤积，治疗不及时会影响患者的生活质量[1]。目前，临床推荐乳腺脓肿患者进行手术治疗，而临床常用的手术方式是传统切开引流术和脓腔置管冲洗技术治疗，主要原理均为根治性的清除病灶并且及时清除病灶周围的脓肿组织，从而降低癌变的可能性[2]。但是传统切开引流术的手术时间较长，伤害性较大，慢慢不被患者所接受，而脓腔置管冲洗技术对于传统的引流手术而言，具有切口小、手术时间短、创伤小、恢复快、痛苦少、术后感染率低的优点，从而被大众所认可[3-4]。本研究探讨哺乳期乳腺脓肿患者应用脓腔置管冲洗的临床效果及对VAS、ADL评分的影响，现报道如下。

1 资料与方法

1.1 一般资料 选取2017年12月-2019年12月本院治療的86例哺乳期乳腺脓肿患者，纳入标准：处于哺乳期，存在不同的肿胀、发热等症状，B超检测确诊为乳腺脓肿;符合治疗适应证，且均能耐受。……