您的位置:山东大学 -> 科技期刊社 -> 《山东大学学报(医学版)》

山东大学学报 (医学版) ›› 2018, Vol. 56 ›› Issue (9): 1-5.doi: 10.6040/j.issn.1671-7554.0.2018.684

• 专家述评 •    

非哺乳期感染性乳腺脓肿诊疗策略

余之刚,周飞   

  1. 山东大学第二医院乳腺外科, 山东 济南 250033
  • 发布日期:2022-09-27
  • 通讯作者: 周飞. E-mail:zflywin@163.com
  • 基金资助:
    公益性行业科研专项(201502027);山东省自然科学基金重点项目(ZR2014HZ004);济南市临床医学科技创新计划(201602146)

Management of non-lactational infectious breast abscesses

YU Zhigang, ZHOU Fei   

  1. Department of Breast Surgery, the Second Hospital of Shandong University, Jinan 250033, Shandong, China
  • Published:2022-09-27

摘要: 非哺乳期感染性乳腺脓肿是一组发生在女性非哺乳期的非特异性炎症,以乳晕下或乳房周围脓肿为主要临床表现,脓肿容易破溃形成窦道或皮肤溃疡,经久不愈,严重影响女性的生活质量。其病因和发病机制目前尚未得到充分阐明,治疗方案也没有统一的认识。结合该领域最新研究进展,对非哺乳期感染性乳腺脓肿流行病学、危险因素及其诊疗方案进行总结。

关键词: 非哺乳期乳腺脓肿, 病因, 危险因素, 诊断, 治疗

Abstract: Non-lactational breast abscesses are a group of non-specific inflammatory disease that occurred in non-lactating women. The main clinical manifestations are subareolar or peripheral abscesses. If not treated, the abscess will brust spontaneously and form mammary duct fistula, which seriously affect the quality of life of wowen. The etiology and 山 东 大 学 学 报 (医 学 版)56卷9期 -余之刚,等.非哺乳期感染性乳腺脓肿诊疗策略 \=-pathogenesis of non-lactational breast abscesses have not been fully elucidated yet and there is no definitive therapeutic strategy for such disease. Here, in summary of the up-to-date research progress, we review the epidemiology, risk factors and the treatment of this disorder.

Key words: Non-lactational breast abscesses, Etiology, Risk factors, Diagnosis, Treatment

中图分类号: 

  • R655.8
[1] Espínola-Docio B, Costa-Romero M, Díaz-Gómez NM, et al. Mastitis update[J]. Archivos Argentinos De Pediatria, 2016, 114(6): 576-576.
[2] Angelopoulou A, Field D, Ryan CA, et al. The microbiology and treatment of human mastitis[J]. Med Microbiol Immunol, 2018, 207(5): 1-12.
[3] Liu L, Zhou F, Wang P, et al. Periductal mastitis: an inflammatory disease related to bacterial infection and consequent immune responses?[J]. Mediators Inflamm, 2017: 5309081. doi: 10.1155/2017/5309081.
[4] Thornton JW, Argenta LC, McClatchey KD, et al. Studies on the endogenous flora of the human breast[J]. Ann Plast Surg, 1988, 20(1): 39-42.
[5] Urbaniak C, Cummins J, Brackstone M, et al. Microbiota of human breast tissue[J]. Appl Environ Microbiol, 2014, 80(10):3007-3014.
[6] Versluijs-Ossewaarde FNL, Roumen RMH, Goris RJA. Subareolar breast abscesses: characteristics and results of surgical treatment[J]. Breast Journal, 2015, 11(3): 179-182.
[7] Ramalingam K, Vuthaluru S, Srivastava A, et al. Ultra structural changes occurring in duct ectasia and periductal mastitis and their significance in etiopathogenesis[J]. PLoS One, 2017, 12(3): e0173216. doi:10.1371/journal.pone.0173216.eCollection 2017.
[8] Al BK, Al MA, Rotimi VO. A study of the microbiology of breast abscess in a teaching hospital in Kuwait[J]. Med Princ Pract, 2011, 20(5): 422-426.
[9] Barron AU, Luk S, Phelan HA, et al. Do acute-care surgeons follow best practices for breast abscess management? A single-institution analysis of 325 consecutive cases[J]. J Surg Res, 2017: 169-171. doi: 10.1016/j.jss.2017.05.013.
[10] Poojary I, Kurian A, Jayalekshmi VA, et al. Corynebacterium species causing breast abscesses among patients attending a tertiary care hospital in Chennai, South India[J]. Scand J Infect Dis, 2017, 49(7): 528-531.
[11] Kumari K, Das B, Adhya A, et al. Nicotine associated breast cancer in smokers is mediated through high level of EZH2 expression which can be reversed by methyltransferase inhibitor DZNepA[J]. Cell Death Dis, 2018, 9(2): 152.
[12] Bharat A, Gao F, Aft RL, et al. Predictors of primary breast abscesses and recurrence[J]. World J Surg, 2009, 33(12): 2582-2586.
[13] Gollapalli V, Liao J, Dudakovic A, et al. Risk factors for development and recurrence of primary breast abscesses[J]. J Am Coll Surg, 2010, 211(1): 41-48.
[14] Uysal E, Soran A, Sezgin E. Factors related to recurrence of idiopathic granulomatous mastitis: what do we learn from a multicentre study[J]. ANZ J Surg, 2018, 88(6): 635-639.
[15] Arslan S, Öncü F, Eryılmaz MA, et al. Advantages of b-mode ultrasound combined with strain elastography in differentiation of idiopathic granulomatous mastitis from malignant breast lesions[J]. Turk J Med Sci, 2018, 48(1): 16-23.
[16] Sousaris N, Barr RG. Sonographic Elastography of Mastitis[J]. J Ultrasound Med, 2016, 35(8): 1791-1797.
[17] Oztekin PS, Durhan G, Kosar PN, et al. Imaging findings in patients with granulomatous mastitis[J]. Iran J Radiol, 2016, 13(3): e33900.
[18] Scott BG, Silberfein EJ, Huang QP, et al. Rate of malignancies in breast abscesses and argument for ultrasound drainage[J]. Am J Surg, 2006, 192(6): 869-872.
[19] Giacalone PL, Rathat G, Fournet S, et al. Surgical treatment of recurring subareolar abscess using oncoplastic techniques[J]. J Visc Surg, 2010, 147(6): e389-394.
[20] Li S, Grant CS, Degnim A, et al. Surgical management of recurrent subareolar breast abscesses: Mayo Clinic experience[J]. Am J Surg, 2006, 192(4): 528-529.
[21] Eryilmaz R, Sahin M, Hakan TM, et al. Management of lactational breast abscesses[J]. Breast, 2005, 14(5): 375-379.
[22] Christensen AF, Alsuliman N, Nielsen KR, et al. Ultrasound-guided drainage of breast abscesses: results in 151 patients[J]. Br J Radiol, 2014, 78(927): 186-186.
[23] Ulitzsch D, Nyman MK, Carlson RA. Breast abscess in lactating women: US-guided treatment[J]. Radiology, 2004, 232(3): 904-904.
[24] Berna-Serna JD, Madrigal M, Berna-Serna JD. Percutaneous management of breast abscesses. an experience of 39 cases[J]. Ultrasound Med Biol, 2004, 30(1): 1-6.
[25] Ozseker B, Ozcan UA, Rasa K, et al. Treatment of breast abscesses with ultrasound-guided aspiration and irrigation in the emergency setting[J]. Emerg Radiol, 2008, 15(2): 105-105.
[26] OHara RJ, Dexter SPL, Fox MJN. Conservative management of infective mastitis and breast abscesses after ultrasonographic assessment[J]. British Journal of Surgery, 2010, 83(10): 1413-1414.
[27] Giess CS, Golshan M, Flaherty K, et al. Clinical experience with aspiration of breast abscesses based on size and etiology at an academic medical center[J]. Journal of Clinical Ultrasound, 2015, 42(9): 513-521.
[28] Chandika AB, Gakwaya AM, Elsie KM, et al. Ultrasound Guided Needle Aspiration versus Surgical Drainage in the management of breast abscesses: a Ugandan experience[J]. BMC Res Notes, 2012, 5(1): 1-7.
[29] Leborgne F, Leborgne F. Treatment of breast abscesses with sonographically guided aspiration, irrigation, and instillation of antibiotics[J]. AJR Am J Roentgenol, 2003, 181(4): 1089-1091.
[30] Elagili F, Abdullah N, Fong L, et al. Aspiration of breast abscess under ultrasound guidance: outcome obtained and factors affecting success[J]. Asian J Surg, 2007, 30(1): 40-44.
[31] Tan YM, Yeo A, Chia KH, et al. Breast abscess as the initial presentation of squamous cell carcinoma of the breast[J]. Eur J Surg Oncol, 2002, 28(1): 91-93.
[32] Naeem M, Rahimnajjad MK, Rahimnajjad NA, et al. Comparison of incision and drainage against needle aspiration for the treatment of breast abscess[J]. Am Surg, 2012, 78(11): 1224-1227.
[33] Kang Y, Kim YM. Comparison of needle aspiration and vacuum-assisted biopsy in the ultrasound-guided drainage of lactational breast abscesses[J]. Ultrasonography, 2016, 35(2): 148-152.
[34] Beechey-Newman N, Kothari A, Kulkarni D, et al. Treatment of mammary duct fistula by fistulectomy and saucerization[J]. World J Surg, 2006, 30(1): 63-68.
[35] Falco G, Foroni M, Castagnetti F, et al. Ultrasound-guided percutaneous catheter drainage of large breast abscesses in lactating women: how to preserve breastfeeding safely[J]. Breastfeed Med, 2016, 11: 555-556.
[36] Kamath RS, Sudhakar D, Gardner JG, et al. Guidelines vs actual management of skin and soft tissue infections in the emergency department[J]. Open Forum Infect Dis, 2018, 5(1): ofx188. doi: 10.1093/ofid/ofx188.
[37] Sartelli M, Malangoni MA, May AK, et al. World Society of Emergency Surgery(WSES)guidelines for management of skin and soft tissue infections[J]. World J Emerg Surg, 2014, 9(1): 57. doi: 10.1186/1749-7922-9-57.
[38] 陈少君. 抗生素联合强的松治疗急性脓肿型非哺乳期乳腺炎的疗效观察[J].北方药学,2017, 14(6): 89-90.
[39] Ferrara JJ, Leveque J, Dyess DL, et al. Nonsurgical management of breast infections in nonlactating women. A word of caution[J]. Am Surg, 1990, 56(11): 668-671.
[1] 李波波 李道堂 刘曙光 王兴武. 食管癌患者血清中DKK-1的表达[J]. 山东大学学报(医学版), 2209, 47(6): 58-61.
[2] 徐平 于国放 李霞. 不同类型甲状腺上动脉PSV对Graves病与桥本氏甲状腺炎鉴别诊断的价值[J]. 山东大学学报(医学版), 2209, 47(6): 62-64.
[3] 王欣,邢春燕,杨艳平. 血清磷酸丙酮酸水合酶检测对诊断侵袭性白念珠菌感染的临床价值[J]. 山东大学学报(医学版), 2209, 47(6): 92-94.
[4] 巩性军,吴树明,张供,李守先,庞昕焱. 无顶冠状静脉窦综合征的诊断和外科治疗[J]. 山东大学学报(医学版), 2209, 47(6): 129-.
[5] 孙文雄,吴日超,郑贤静,李丽, 张友忠. 宫颈血管周上皮样细胞肿瘤1例[J]. 山东大学学报 (医学版), 2022, 60(9): 125-128.
[6] 吴瑞芳,李长忠. 女性生育力保护的现状与进展[J]. 山东大学学报 (医学版), 2022, 60(9): 1-7.
[7] 王丽慧,高敏,孔北华. 子宫血管肉瘤2例报告并文献复习[J]. 山东大学学报 (医学版), 2022, 60(9): 108-112.
[8] 韩靖,贾春玲. 肺癌患者胸外手术前治疗牙周基础疾病对预防术后肺炎发生的效果评价[J]. 山东大学学报 (医学版), 2022, 60(9): 113-118.
[9] 王文静,刘博策,毕见海,霍然. 超声引导下平阳霉素联合聚桂醇硬化治疗94例囊性淋巴管畸形的疗效[J]. 山东大学学报 (医学版), 2022, 60(8): 72-78.
[10] 彭超,周应芳. 子宫腺肌病的药物治疗进展[J]. 山东大学学报 (医学版), 2022, 60(7): 20-25.
[11] 秦静,杨飞,陈谦,夏涵岱,刘延国,王秀问. 晚期驱动基因阴性、PD-L1表达阴性非鳞非小细胞肺癌一线治疗方案的网状Meta分析[J]. 山东大学学报 (医学版), 2022, 60(7): 74-82.
[12] 王福立,孙银萍,秦杰,荣建胜. DC-CIK细胞联合EGFR-TKI治疗35例老年晚期EGFR突变肺癌的效果[J]. 山东大学学报 (医学版), 2022, 60(7): 110-117.
[13] 姚雪,卢冉冉,孙淑玲,高翠平,肖茹,王书会. 风湿性心脏病患者瓣膜置换术后医院感染风险预测评分模型的构建[J]. 山东大学学报 (医学版), 2022, 60(6): 90-96.
[14] 查菁,郭婧,左秀丽. 少见类型肠梗阻病因病例报告1例并文献复习[J]. 山东大学学报 (医学版), 2022, 60(6): 130-132.
[15] 王菊,高帅,范玉琛,王凯. 肝衰竭并发真菌感染综合治疗1例[J]. 山东大学学报 (医学版), 2022, 60(5): 125-128.
Viewed
Full text


Abstract

Cited

  Shared   
  Discussed   
No Suggested Reading articles found!