泼尼松龙治疗乳腺肉芽肿性小叶炎的临床疗效

摘要

Objective:To explore the clinical effect of prednisone on granulomatous lobular mastitis.Methods:The study on 64 cases pathologically diagnosed with granulomatous lobular mastitis involved the clinical data,treatment and effect from June 2014 to December 2015 in the Second Affiliated Hospital of Xi'an Jiaotong University.64 patients were divided into observation and control group according to different treatments.32 cases in observation group received therapeutic hormone before surgery,while 32 cases in the control group did not have hormone,directly to surgery.Results:All patients were intravenously gived anti-infection for 1 week,32 cases in observation group received hormone before surgery,3 patients had marked effect(9.4%),24 patients were effective(75%),and 5 patients were inefficient(15.6%).The total effective rate was 84.4% including 3 patients without surgery.7 patients were surgical drainage in first stage,mammary gland disease was removed in second stage breast surgery.22 patients were removed part breast lesions.All patients were followed up for 6 months after surgery.No cases were recurrent.32 cases in the control group did not receive hormone before surgery,among them.No patients had obvious effect,6 patients were effective(18.8%),and 26 patients were inefficient(81.3%).Accordingly,the total effective rate was 18.8%.25 patients performed surgical drainage in first stage,mammary gland disease was removed in second stage breast surgery.6 patients removed part breast lesions.1 patient was removed the entire breast.During the follow-up of 6 months after surgery,2 cases were recurrent(the recurrence rate was 6.3%).There were statistically significant differences in the total effective rate and recurrence rate(P<0.05).Conclusion:The clinical treatment of prednisone on granulomatous lobular mastitis were obvious,reduced the surgical trauma and the recurrence of the disease effectively.%目的:探讨泼尼松龙治疗乳腺肉芽肿性小叶炎的临床疗效.方法:纳入2014年6月-2015年12月西安交通大学第二附属医院收治的64例病理确诊为乳腺肉芽性小叶炎患者,对临床资料、治疗方案及治疗效果进行回顾性分析,64例患者根据治疗方式不同分为观察组32例,即口服泼尼松龙后手术治疗,对照组32例不予以泼尼松龙治疗,直接手术治疗.结果:所有患者住院初期均予以抗炎治疗1周,观察组32例患者术前口服泼尼松龙,3例(9.4%)显效,24例(75%)有效,5例(15.6%)无效,总有效率84.4%,3例免于手术治疗,7例行一期切开引流,二期切除病灶乳腺成形手术,22例行单纯乳腺区段切除术,术后随访6个月,无一例复发;对照组32例患者术前未口服泼尼松龙,其中0例(0%)显效,6例(18.8%)有效,26例(81.3%)无效,总有效率18.8%,25例行一期切开引流,二期切除病灶乳腺成形手术,6例行乳腺区段切除术,1例行单纯乳房切除术,术后随访6个月,2例复发,复发率6.3%,两组对比总有效率和复发率均有统计学意义(P<0.05).结论:泼尼松龙治疗乳腺肉芽肿性小叶炎临床疗效明显,有效减小了手术创伤,降低了疾病术后复发.