目的 比较超声引导穿刺置管引流与常规手术切开引流治疗乳腺脓肿的临床疗效。方法 选取71例乳腺脓肿患者,随机分成超声引导置管引流组(35例,简称置管组)和常规手术切开引流组(36例,简称常规组),对两组手术时间、术中出血量、体温恢复正常时间、血象恢复正常时间、疼痛评分、换药次数、脓腔愈合时间、瘢痕长度、切口外观满意度等方面进行比较。结果 置管组的手术时间(30.54±12.17) min、术中出血量(6.13±1.83) ml,均少于常规组(39.28±14.36) min, (14.27±3.25) ml,差异有统计学意义(P＜0.01 );两组术后体温恢复正常时间和血象恢复正常时间比较,差异无统计学意义;置管组在疼痛评分、换药次数、脓腔愈合时间、瘢痕长度和切口外观满意度方面明显优于常规组(P＜0.01);两组术后并发症发生率和复发率比较,差异无统计学意义。结论 对液化相对完全的乳腺脓肿,经皮置管引流可缩短疗程,减轻痛苦,保护乳房美观,值得推广。

Objective To compare the clinical effect of ultrasound-guided catheterization drainage and traditional surgical drainage in the treatment of breast abscess. Methods Seventy-one patients with breast abscess were randomly divided into the ultrasound guided percutaneous catheterization drainage group (35 cases, the tube group), and the incision drainage group (36 cases, the routine operation group). The items such as operation time, amount of bleeding, body temperature, incidence of postoperative complications rates were analysed and compared between the two groups. Results The operation time and the amount of bleeding of the catheter group operation was less than in the conventional group(30.54±12.17) min vs (39.28±14.36) min; (6.13±1.83) ml vs (14.27±3.25) ml. The difference was statistically significant(P<0.01). The body temperature and WBC recovering to normal during same time in the conventional therapy group were same to the percutaneous drainage group. The items in the percutaneous drainage group such as pain index, dressing time, pus cavity healing time and length of incision scar were superior to those in the conventional therapy group(P<0.01). The incidence of postoperative complications and recurrence rates in the percutaneous drainage group were similer to those in the conventional therapy group (P>0.05). Conclusions Percutaneous catheterization drainage is a good way to treat the completely liquefacient breast abscess, which can shorten the course of treatment, relieve pain and protect the breast appearance.