目的

比较超声引导下多孔硅胶管引流及传统纱条引流在乳腺导管扩张症脓肿型切开引流术中的优劣势。

方法

回顾性分析成都市第三人民医院2012 年8 月至2014 年11 月间收治的152 例乳腺导管扩张症脓肿型患者的临床资料,按照1 ∶1 配对研究(按照年龄±2.0 岁,发病时间±2.0 月,脓腔长径长度±2.0 cm 配对),筛选30 例采用超声引导下多孔硅胶管引流的患者作为试验组,30 例传统纱条填塞患者作为对照组。 术后记录两组患者的首次换药痛苦评分、切口长度、每日换药时间及切口愈合时间、患者切口是否出现内陷的情况。 两组间切口长度、切口愈合时间等资料的比较采用配对Wilcoxon 秩和检验,切口内陷率的比较采用配对χ² 检验。

结果

试验组首次换药疼痛评分明显低于对照组[M(Q_R):5.0(1.0)比7.0(2.3),Z=3.355,P＜0.001];试验组切口长度较对照组短[M(Q_R):1.5(0.6) cm比2.2(1.1) cm, Z=4.375, P＜0.001];试验组每日换药时间比对照组明显缩短[M(Q_R): 5.3(2.0) min比6.3(2.5) min, Z=4.564,P＜0.001];试验组的切口内陷率较对照组明显降低[23.3%(7/30)比63.3%(19/30),χ²=7.563,P=0.004];试验组与对照组切口愈合时间的差异无统计学意义[M(Q_R):50.0(11.8)d 比51.5(20.8)d,Z=0.164,P=0.870]。

结论

应用超声引导下多孔硅胶管引流术治疗乳腺导管扩张症脓肿期患者,可以减轻换药时患者的疼痛程度、精简换药程序、节省换药时间,使患者切口外观更加美观,在临床上具有应用价值。

Objective

To investigate the superiority and inferiority of porous silica tube and traditional gauze in ultrasound-guided incision and drainage for mammary ductal ectasia abscess.

Methods

The clinical data of totally 152 cases of mammary ductal ectasia abscess treated in the Third People's Hospital of Chengdu City from August 2012 to November 2014 were retrospectively analyzed. According to the principle of 1 ∶1 paired study (age ± 2.0 years, time of onset ± 2.0 months, the largest diameter of abscess ± 2.0 cm), we screened 30 cases receiving ultrasound-guided porous silica tube drainage as the experimental group, 30 cases receiving traditional gauze drainage as the control group. After operation, the patients' pain in the first dressing change, incision length, average time of daily dressing, wound healing time and incision retraction in two groups were recorded. Measurement data including incision length and wound healing time were analyzed using Wilcoxon rank sum test, and the rates of incision retraction were compared using paired χ² test.

Results

In the experimental group, the pain caused by the first dressing change was significantly lower than that of the control group [M(Q_R): 5.0 (1.0) vs 7.0 (2.3), Z=3.355, P＜0.001],so were average incision length[M(Q_R):1.5 (0.6) cm vs 2.2 (1.1) cm, Z=4.375, P＜0.001], average time of daily dressing [M(Q_R):5.3 (2.0) min vs 6.3 (2.5) min, Z=4.564, P＜0.001], and the incision retraction rate [23.3%(7/30) vs 63.3%(19/30),χ²=7.563, P=0.004]. There was no significant difference in wound healing time between the experimental group and the control group [M(Q_R): 50.0 (11.8) d vs 51.5 (20.8) d, Z=0.164, P=0.870].

Conclusion

Ultrasound-guided porous silica tube drainage can reduce the patients pain in dressing change, simplify the procedure, save the time and improve the cosmetic effect of incision in the treatment of mammary ductal ectasia abscess.