目的

探讨哺乳期急性乳腺炎发展成乳腺脓肿阶段的相关因素。

方法

回顾性分析2013 年1 月至2014年3 月本科收治的111 例哺乳期乳腺炎及乳腺脓肿患者资料,其中哺乳期乳腺炎92 例,乳腺脓肿19 例。 从发热与否、发热时间、感染部位、非医务人员按摩史、抗生素使用情况、是否换用敏感抗生素、乳汁细菌培养结果、有无肿块、年龄及血常规方面进行统计,采用单因素分析及非条件Logistic 回归进行危险因素分析。

结果

单因素分析显示,脓肿组发热时间＞2 d、病变位于乳头乳晕区以及有非医务人员按摩史者分别占12/19、9/19、5/19,高于非脓肿组的27.2%(25/92)、15.2%(14/92)、4.3%(4/92),两组间差异均有统计学意义(χ²=9.176、9.909、7.465,P=0.002、0.002、0.006)。 多因素logistic 回归分析显示,发热时间＞2 d、乳头乳晕区发病、有非医务人员按摩史是哺乳期乳腺脓肿形成的危险因素(OR=4.171,95%CI: 1. 325 ～13. 135,P=0. 015;OR=5. 153, 95% CI: 1. 564 ～16. 972,P=0. 007;OR=10.184,95%CI: 2.017 ～51.428,P=0.005)。

结论

发热时间＞2 d、病变位于乳头乳晕区及有非医务人员按摩史的哺乳期急性乳腺炎患者,容易发展成为乳腺脓肿,治疗要积极。

Objective

To explore the related factors in the development from acute lactation mastitis to breast abscess.

Methods

The clinical data of 111 patients who had lactation mastitis or breast abscess in our department from January 2013 to March 2014, including 92 cases of lactation mastitis and 19 cases of breast abscess, were analyzed retrospectively. Single factor analysis and unconditional logistic regression analysis were used from the following aspects: fever or not, duration of fever, infection site, massage history given by nonmedical staff, use of antibiotics,switching to sensitive antibiotics or not,bacterial culture of breast milk,mass,age, and routine blood test.

Results

Single factor analysis showed that in breast abscess group, the proportion of the patients with duration of fever ＞2 d, lesions in nipple-areola area and massage history given by nonmedical staff were 12/19,9/19 and 5/19, significantly higher than 27.2% (25/92), 15.2% (14/92) and 4.3% (4/92) in non-abscess group (χ²=9.176,9.909,7.465, P=0.002,0.002,0.006). Multiple factor logistic regression analysis showed that duration of fever ＞2 d, lesions in nipple-areola area and massage history given by non-medical staff were risk factors in breast abscess during lactation (OR=4.171, 95%CI: 1.325-13.135,P=0.015; OR=5.153,95%CI: 1.564-16.972,P=0.007;OR=10.184, 95%CI: 2.017-51.428,P=0.005).

Conclusion

The patients with duration of fever ＞2 d, lesions in nipple-areola area and massage history given by non-medical staff are prone to develop breast abscess and the physicians should pay more attention to their treatment.