彩色多普勒超声引导下微创介入穿刺联合臭氧腔内注入治疗乳腺脓肿的临床效果
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摘要
目的:评价彩色多普勒超声引导下微创介入穿刺联合臭氧腔内注入治疗乳腺脓肿的临床效果。方法:选取2015年10月至2017年10月来兖矿新里程总医院就诊的135例哺乳期乳腺脓肿患者为研究对象,按照随机数字法则分为3组,A组采用传统开放式引流术进行治疗,B组采用彩色多普勒超声引导下微创介入穿刺联合抗生素冲洗治疗,C组彩色多普勒超声引导下微创介入穿刺联合臭氧腔内注入治疗,然后对比3组临床疗效的安全性。结果:C组的愈合时间、换药次数明显低于A,B组(P<0.05),B组的愈合时间、换药次数明显低于A组(P<0.05),B组和C组发生乳瘘数明显低于A组(P<0.05),继续哺乳数明显高于A组(P<0.05);治疗后,3组VAS评分均明显降低(P<0.05),其中B组和C组VAS评分明显低于A组(P<0.05);A组创口愈合满意度为66.67%,B组为88.89%,C组为91.11%,B组和C组满意度明显高于A组(P<0.05);治疗后,3组炎性因子CRP,P物质以及IFN-γ水平均明显下降(P<0.05),其中C组炎性因子水平明显低于B组和A组(P<0.05),B组明显低于A组(P <0. 0 5)。结论:彩色多普勒超声引导下微创介入穿刺联合臭氧腔内注入治疗乳腺脓肿效果更佳,值得在临床推广应用。
Objective: To evaluate the clinical effect of minimally invasive puncture guided by color doppler ultrasound combined with ozone cavity injection in the treatment of mammary abscess. Methods: In October 2015 to October 2017, 135 patients with breast abscess from Yankuang New Mileage General Hospital were selected as the research objects. According to the law of random numbers, the patients were divided into three groups: group A was given traditional open drainage treatment, group B was given color doppler ultrasound guided minimally invasive interventional puncture with antibiotic treatment, group C was given color doppler ultrasound guided minimally invasive interventional puncture combined ozone cavity injection treatment, and the safety of the three groups of patients with clinical curative effect were compared. Results: The healing time, switching times of group C were obviously lower than those of group A, B(P<0.05); healing time, switching times of group B were obviously lower than those of group A(P<0.05), mammary fistula in group B and group C were significantly lower than that of group A(P<0.05), and the number of continued breastfeeding was significantly higher than that of group A(P<0.05). After the treatment, the VAS scores of group B and C were obviously lower than those in group A(P<0.05); the satisfaction degree of wound healing was 66.67% in group A, 88.89% in group B, 91.11% in group C, and that in group B and group C were significantly higher than that in group A(P<0.05). After the treatment,the levels of inflammatory cytokines CRP, substance P and IFN-γ of the three groups decreased significantly(P<0.05). Including inflammatory factor levels of group C was lower than that in group B and group A(P<0.05),group B was lower than that in group A(P<0.05). Conclusion: Color doppler ultrasound guided minimally invasive interventional puncture combined ozone cavity injection has better effect to treat breast abscess, which is worth popularizing in clinical application.
Objective: To evaluate the clinical effect of minimally invasive puncture guided by color doppler ultrasound combined with ozone cavity injection in the treatment of mammary abscess. Methods: In October 2015 to October 2017, 135 patients with breast abscess from Yankuang New Mileage General Hospital were selected as the research objects. According to the law of random numbers, the patients were divided into three groups: group A was given traditional open drainage treatment, group B was given color doppler ultrasound guided minimally invasive interventional puncture with antibiotic treatment, group C was given color doppler ultrasound guided minimally invasive interventional puncture combined ozone cavity injection treatment, and the safety of the three groups of patients with clinical curative effect were compared. Results: The healing time, switching times of group C were obviously lower than those of group A, B(P<0.05); healing time, switching times of group B were obviously lower than those of group A(P<0.05), mammary fistula in group B and group C were significantly lower than that of group A(P<0.05), and the number of continued breastfeeding was significantly higher than that of group A(P<0.05). After the treatment, the VAS scores of group B and C were obviously lower than those in group A(P<0.05); the satisfaction degree of wound healing was 66.67% in group A, 88.89% in group B, 91.11% in group C, and that in group B and group C were significantly higher than that in group A(P<0.05). After the treatment,the levels of inflammatory cytokines CRP, substance P and IFN-γ of the three groups decreased significantly(P<0.05). Including inflammatory factor levels of group C was lower than that in group B and group A(P<0.05),group B was lower than that in group A(P<0.05). Conclusion: Color doppler ultrasound guided minimally invasive interventional puncture combined ozone cavity injection has better effect to treat breast abscess, which is worth popularizing in clinical application.
引文
1.张云锁,彭金娟,池华茂,等.超声实时引导下穿刺冲洗在哺乳期乳腺脓肿治疗中的应用[J].中国妇幼保健, 2016, 31(7):1541-1543.ZHANG Yunsuo, PENG Jinjuan, CHI Huamao, et al. Application of real-time ultrasound-guided puncture irrigation in the treatment of lactation mammary abscess[J]. Chinese Journal of Maternal and Child Health, 2016, 31(7):1541-1543.
2 .丁松涛,何湘萍,马祥君,等.超声引导下脓肿穿刺术治疗哺乳期乳腺脓肿的临床分析[J].中华乳腺病杂志(电子版), 2017,11(3):157-161.DING Songtao, HE Xiangping, MA Xiangjun, et al. Clinical analysis of lactational breast abscess treated by ultrasound-guided aspiration[J].Chinese Journal of Breast Diseases. Electronic Edition, 2017, 11(3):157-161.
3 .高雅军,马祥君,何湘萍,等.哺乳期急性乳腺炎发展成乳腺脓肿的相关因素分析[J].中华乳腺病杂志(电子版), 2015, 9(1):32-35.GAO Yajun, MA Xiangjun, HE Xiangping, et al. Related factor analysis in breast abscess developed from acute lactation mastitis[J]. Chinese Journal of Breast Diseases. Electronic Edition, 2015, 9(1):32-35.
4 .Inoue T, Kinoshita H, Okada S, et al. Wideband Doppler ultrasoundguided mini-endoscopic combined intrarenal surgery as an effective and safe procedure for management of large renal stones:a preliminary report[J]. Urology, 2016, 95(9):60-66.
5 .BabaliarosVC,GreenbaumAB,KhanJM,etal.Intentional percutaneous laceration of the anterior mitral leaflet to prevent outflow obstruction during transcatheter mitral valve replacement:first-inhuman experience[J]. JACC Cardiovasc Interv, 2017, 10(8):798-809.
6 .Rana SS, Sharma R, Ahmed SU, et al. Endoscopic ultrasound-guided transmural drainage of walled-off pancreatic necrosis in patients with portalhypertensionandintra-abdominalcollaterals[J].IndianJ Gastroenterol, 2017, 36(5):400-404.
7 .MugnaiG,SieiraJ,CiconteG,etal.Oneyearincidenceofatrial septal defect after PV isolation:a comparison between conventional radiofrequencyandcryoballoonablation[J].PACE,2015,38(9):1049-1057.
8 .姚育芝,马宏民,潘玉鸿,等.留置针穿刺引流结合乳腺疏通治疗在哺乳期乳腺脓肿中的应用[J].临床与病理杂志, 2018, 38(2):276-281.YAOYuzhi,MAHongmin,PANYuhong,etal.Applicationof indwelling needle puncture drainage combined with breast dredging therapy in breast abscess during lactation[J]. Journal of Clinical and Pathological Research, 2018, 38(2):276-281.
9 .尹永硕,冠潇,王月美,等.超声引导下多向式负压引流联合敏感抗生素冲洗治疗乳腺脓肿的临床效果评价[J].中华乳腺病杂志(电子版), 2016, 10(2):92-96.YIN Yongshuo, GUAN Xiao, WANG Yuemei, et al. Ultrasound-guided minimally invasive intervention and rinsing with sensitive antibiotics for breast abscess[J]. Chinese Journal of Breast Diseases. Electronic Edition, 2016, 10(2):92-96.
10 .王丽萍,王利娴,庞海艳,等.臭氧治疗对糖尿病足局部组织VEGF, TGF-β, PDGF表达的变化影响[J].中国医药导刊, 2017,19(5):21.WANG Liping, WANG Lixian, PANG Haiyan, et al. Effects of ozone therapy on the expression of VEGF, TGF-βand PDGF in diabetic foot[J]. Chinese Journal of Medical Guide, 2017, 19(5):21.
11 .石英哲.多节段腰间盘突出应用臭氧配合手术治疗的术后护理效果分析[J].中国卫生标准管理, 2016, 7(4):227-228.SHI Yingzhe. Analysis of nursing effect of multi segmental lumbar disc herniation by ozone treatment combined with surgery[J]. China Health Standard Management, 2016, 7(4):227-228.
12 .王孟菲.活血解毒化痰法对浆细胞性乳腺炎患者的Hs-CRP、PRL及细胞因子IL-1β、IL-6、TNF-α的影响[D].合肥:安徽中医药大学, 2015.WANG Mengfei. Effects of activating blood and detoxifying phlegm on Hs-CRP, PRL and cytokines IL-1, IL-6, TNF-αin plasma cell mastitis patients[D]. Hefei:Anhui University of Chinese Medicine, 2015.
2 .丁松涛,何湘萍,马祥君,等.超声引导下脓肿穿刺术治疗哺乳期乳腺脓肿的临床分析[J].中华乳腺病杂志(电子版), 2017,11(3):157-161.DING Songtao, HE Xiangping, MA Xiangjun, et al. Clinical analysis of lactational breast abscess treated by ultrasound-guided aspiration[J].Chinese Journal of Breast Diseases. Electronic Edition, 2017, 11(3):157-161.
3 .高雅军,马祥君,何湘萍,等.哺乳期急性乳腺炎发展成乳腺脓肿的相关因素分析[J].中华乳腺病杂志(电子版), 2015, 9(1):32-35.GAO Yajun, MA Xiangjun, HE Xiangping, et al. Related factor analysis in breast abscess developed from acute lactation mastitis[J]. Chinese Journal of Breast Diseases. Electronic Edition, 2015, 9(1):32-35.
4 .Inoue T, Kinoshita H, Okada S, et al. Wideband Doppler ultrasoundguided mini-endoscopic combined intrarenal surgery as an effective and safe procedure for management of large renal stones:a preliminary report[J]. Urology, 2016, 95(9):60-66.
5 .BabaliarosVC,GreenbaumAB,KhanJM,etal.Intentional percutaneous laceration of the anterior mitral leaflet to prevent outflow obstruction during transcatheter mitral valve replacement:first-inhuman experience[J]. JACC Cardiovasc Interv, 2017, 10(8):798-809.
6 .Rana SS, Sharma R, Ahmed SU, et al. Endoscopic ultrasound-guided transmural drainage of walled-off pancreatic necrosis in patients with portalhypertensionandintra-abdominalcollaterals[J].IndianJ Gastroenterol, 2017, 36(5):400-404.
7 .MugnaiG,SieiraJ,CiconteG,etal.Oneyearincidenceofatrial septal defect after PV isolation:a comparison between conventional radiofrequencyandcryoballoonablation[J].PACE,2015,38(9):1049-1057.
8 .姚育芝,马宏民,潘玉鸿,等.留置针穿刺引流结合乳腺疏通治疗在哺乳期乳腺脓肿中的应用[J].临床与病理杂志, 2018, 38(2):276-281.YAOYuzhi,MAHongmin,PANYuhong,etal.Applicationof indwelling needle puncture drainage combined with breast dredging therapy in breast abscess during lactation[J]. Journal of Clinical and Pathological Research, 2018, 38(2):276-281.
9 .尹永硕,冠潇,王月美,等.超声引导下多向式负压引流联合敏感抗生素冲洗治疗乳腺脓肿的临床效果评价[J].中华乳腺病杂志(电子版), 2016, 10(2):92-96.YIN Yongshuo, GUAN Xiao, WANG Yuemei, et al. Ultrasound-guided minimally invasive intervention and rinsing with sensitive antibiotics for breast abscess[J]. Chinese Journal of Breast Diseases. Electronic Edition, 2016, 10(2):92-96.
10 .王丽萍,王利娴,庞海艳,等.臭氧治疗对糖尿病足局部组织VEGF, TGF-β, PDGF表达的变化影响[J].中国医药导刊, 2017,19(5):21.WANG Liping, WANG Lixian, PANG Haiyan, et al. Effects of ozone therapy on the expression of VEGF, TGF-βand PDGF in diabetic foot[J]. Chinese Journal of Medical Guide, 2017, 19(5):21.
11 .石英哲.多节段腰间盘突出应用臭氧配合手术治疗的术后护理效果分析[J].中国卫生标准管理, 2016, 7(4):227-228.SHI Yingzhe. Analysis of nursing effect of multi segmental lumbar disc herniation by ozone treatment combined with surgery[J]. China Health Standard Management, 2016, 7(4):227-228.
12 .王孟菲.活血解毒化痰法对浆细胞性乳腺炎患者的Hs-CRP、PRL及细胞因子IL-1β、IL-6、TNF-α的影响[D].合肥:安徽中医药大学, 2015.WANG Mengfei. Effects of activating blood and detoxifying phlegm on Hs-CRP, PRL and cytokines IL-1, IL-6, TNF-αin plasma cell mastitis patients[D]. Hefei:Anhui University of Chinese Medicine, 2015.