周秀　吴欢

[摘要]目的：分析火針洞式联合提脓药捻引流术治疗对乳腺脓肿患者临床治愈率、切口愈合及乳房美观的影响。方法：选择2018年12月-2019年12月笔者科室收治的85例乳腺脓肿患者为研究对象，采用随机分组法将患者分为对照组（41例）和研究组（44例），对照组采用传统乳腺脓肿引流术治疗，研究组采用火针洞式联合提脓药捻引流术治疗，对比两组患者的临床治愈率、切口愈合及术后乳房美观度情况。结果：对照组治愈率明显低于研究组（82.93% vs 97.73%）（P<0.05），对照组手术及瘢痕大小、愈合时间、换药天数均明显多于研究组（P<0.05），对照组手术满意度明显低于研究组（85.37% vs 97.73%），复发率明显高于研究组（14.63% vs 2.27%）（P<0.05）;研究组术后并发症发生率仅为4.55%，显著低于对照组并发症发生率21.95%（P<0.05）。结论：火针洞式联合提脓药捻引流术相较于常规乳腺脓肿切开引流术临床效果显著，加速患者愈合进程，且术后并发症发生率低，患者满意度高，复发率低，值得在临床上推广应用。

[关键词]乳腺脓肿;火针洞式联合提脓药捻引流术;临床治愈率;切口愈合;美观度

[中图分类号]R245.31+6    [文献标志码]A    [文章编号]1008-6455（2021）09-0126-03

Effect of Fire-needle Hole Combined with Drainage of Purulent Extraction and Medicinal Fuse on the Clinical Cure Rate， Incision Healing and Breast Aesthetics of Patients with Breast Abscess

ZHOU Xiu，WU Huan

（Outside the Second Ward，Sichuan Second Traditional Chinese Medicine Hospital， Chengdu 610031， Sichuan， China）

Abstract： Objective  To analyze the effect of fire-needle hole combined with drainage of purulent extraction and medicinal fuse on the clinical cure rate， incision healing and breast aesthetics of patients with breast abscess. Methods  85 patients with breast abscess admitted to our hospital from December 2018 to December 2019  were selected as the research object， and were divided into a control group （41 cases） and a study group （44 cases） according to random grouping.The control group was treated with traditional drainage of breast abscess， and the study group was treated with fire-needle hole combined with drainage of purulent extraction and medicinal fuse.  The clinical cure rate， wound healing and postoperative breast aesthetics of patients between the two groups were compared. Results  The cure rate of the control group was significantly lower than that of the study group （82.93% vs 97.73%） （P<0.05）. The wound size， scar size， healing time， and days of dressing change in the control group were significantly more than those in the study group （P<0.05）. The satisfaction with surgery in the control group was significantly lower than that of the study group （85.37% vs 97.73%）， and the recurrence rate was significantly higher than that of the study group （14.63% vs 2.27%） （P<0.05）. The incidence of postoperative complications in the study group was only 4.55%， which was significantly lower than 21.95% in the control group （P<0.05）. Conclusion  Compared with the conventional drainage of breast abscess， fire-needle hole combined with drainage of purulent extraction and medicinal fuse has a significant clinical effect. It can accelerate the healing process of patients， the incidence of postoperative complications is low， the satisfaction of patients is high， and the recurrence rate is low. It is worthy of popularization and application in clinic.

Key words： breast abscess; fire-needle hole combined with drainage of purulent extraction and medicinal fuse; clinical cure rate; incision healing; aesthetic degree

乳腺组织发生的急性化脓性感染又称为急性乳腺炎，主要是因为乳腺出现皲裂、破损，乳腺导管口阻塞，导致乳汁瘀积以及细菌沿淋巴细胞管入侵而引起的，一般好发于产后需进行哺乳的初产妇[1]。若患者未引起重视，乳腺局部出现肿块，经历多天后形成了一个或多个的化脓组织，将进而引起乳腺脓肿[2]。目前，对于乳腺脓肿主要以切开引流来排脓减压、缓解局部症状的手术治疗为主[3]。而在临床治疗过程中发现，有部分患者切除术后，其手术切口过大或乳房改变过大，且具有较高的复发率，对患者从心理、生理及生活负担上均产生了较大影响，大部分患者难以接受[4]。在中医范畴上，乳腺脓肿属“乳痈、乳漏”范畴，主要是由各种原因引起乳腺小叶或导管内分泌物瘀积、分解，致使乳腺组织发生免疫和超敏反应，中医多以“提脓祛腐”为核心并予提脓药捻引流术、火针烙口引流术、刮匙棉捻排脓祛腐术等中医特色疗法治疗，以达到彻底清除病变组织和免疫原，降低复发率的目的[5]。……