主乳管切除联合扩大切除手术对肉芽肿性小叶性乳腺炎患者治疗效果和复发率及预后的影响OA
Effects of major duct excision combined with extended resection on treatment outcome,recurrence rate and prognosis in patients with granulomatous lobular mastitis
目的 探讨主乳管切除联合扩大切除手术对肉芽肿性小叶性乳腺炎(GLM)患者治疗效果、复发率及预后的影响.方法 前瞻性选取2020年4月至2024年4月郑州人民医院乳腺外科收治的GLM患者198例,根据患者病情结合患者意愿分别行单纯病灶切除术(66例,对照组)、扩大切除术(65例,扩大切除组)及主乳管切除联合扩大切除术(67例,联合组).术后门诊或电话随访12个月,比较3组随访6个月时的治疗效果、乳房外形评分、满意度,以及随访12个月时的复发情况、并发症发生情况.结果 总有效率比较,联合组(95.52%,64/67)和扩大切除组(83.08%,54/65)显著高于对照组(68.18%,45/66),联合组显著高于扩大切除组,差异均有统计学意义(χ2=17.117,P<0.001).总满意度比较,联合组(94.03%,63/67)、扩大切除组(92.31%,60/65)显著高于对照组(80.30%,53/66),差异有统计学意义(χ2=7.488,P=0.024),但联合组与扩大切除组比较,差异无统计学意义(P>0.05).术后12个月复发率比较,联合组(1.49%,1/67)、扩大切除组(9.23%,6/65)显著低于对照组(22.73%,15/66),联合组显著低于扩大切除组,差异有统计学意义(χ2=15.526,P<0.001).3组手术相关并发症总发生率比较,差异无统计学意义(P>0.05).结论 主乳管切除联合扩大切除手术能提升GLM患者治疗效果,减少术后12个月内的复发风险,但对患者乳房外观及满意度的影响不显著,且不会明显增加手术相关并发症.
Objective To explore the effects of major duct excision combined with extended resection on treatment outcomes,recurrence rate and prognosis in patients with granulomatous lobular mastitis(GLM).Methods A total of 198 patients with GLM admitted to the Department of Breast Surgery of Zhengzhou People's Hospital from April 2020 to April 2024 were prospectively enrolled.Based on their disease severity and personal preferences,patients were assigned to one of three surgical groups:lesion resection alone(control group,n=66),extended resection alone(extended resection group,n=65),or major duct excision combined with extended resection(combined group,n=67).All patients were followed up for 12 months postoperatively via outpatient visits or telephone interviews.Treatment outcomes,breast cosmetic scores,and patient satisfaction were assessed at 6 months of follow-up,while recurrence and complication rates were evaluated at 12 months of follow-up.Results The overall response rate was significantly higher in the combined group(95.52%,64/67)and the extended resection group(83.08%,54/65)than that in the control group(68.18%,45/66),and was also significantly higher in the combined group than that in the extended resection group(χ2=17.117,P<0.001).The overall satisfaction rate in the combined group(94.03%,63/67)and the extended resection group(92.31%,60/65)was significantly higher than that in the control group(80.30%,53/66)(χ2=7.488,P=0.024);however,no significant difference was observed between the combined group and the extended resection group(P>0.05).At 12 months postoperatively,the recurrence rate was significantly lower in the combined group(1.49%,1/67)and the extended resection group(9.23%,6/65)than in the control group(22.73%,15/66),and was also significantly lower in the combined group than in the extended resection group(χ2=15.526,P<0.001).The overall incidence of surgery-related complications did not differ significantly among the three groups(P>0.05).Conclusions Major duct excision combined with extended resection significantly improves treatment outcomes and reduces the risk of recurrence within 12 months postoperatively in patients with GLM.However,it does not significantly influence breast cosmesis or patient satisfaction,nor does it markedly increase surgeryrelated complications.
叶贝贝;牛冰;冯燕枝;李庆辉
郑州人民医院乳腺外科,郑州 450000郑州人民医院乳腺外科,郑州 450000郑州人民医院乳腺外科,郑州 450000郑州人民医院乳腺外科,郑州 450000
肉芽肿性小叶性乳腺炎主乳管切除术扩大切除手术单纯病灶切除术
granulomatous lobular mastitismajor duct resectionextended resectionlesion resection alone
《感染、炎症、修复》 2026 (1)
57-61,5
河南省医学科技攻关计划联合共建项目(LHGJ20220784)
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