非哺乳期感染性乳腺脓肿诊疗策略

doi:10.6040/j.issn.1671-7554.0.2018.684

摘要/Abstract

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

余之刚,周飞. 非哺乳期感染性乳腺脓肿诊疗策略[J]. 山东大学学报 (医学版), 2018, 56(9): 1-5.

YU Zhigang, ZHOU Fei. Management of non-lactational infectious breast abscesses[J]. Journal of Shandong University (Health Sciences), 2018, 56(9): 1-5.

参考文献

[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.

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