| 摘要 |
Introduction: Breast infections, both mastitis and abscess, are among the most
painful and annoying benign diseases in women. This study was undertaken hoping to
stimulate the interest of the concerned medical specialists. Perhaps more attention to
prompt diagnosis and early intervention could better alleviate the pain and anxiety
suffered by these patients.
Methods: This retrospective study includes 170 female patients diagnosed with
breast infections between January 1989 and December 2005. These patients had in
total 186 admissions into this regional hospital. Surgical incision and drainage (I & D)
were performed 142 times in 128 patients with breast abscess.
Results: Pre-operative symptom duration averaged 10.8 days and total recovery
time averaged 24.1 days. Recurrence occurred in 16 of the 128 cases of abscess and
ten of the recurrent abscesses (62.5%) were located in the sub-areolar area. One
hundred and eight out of the 170 patients received sonographic examination. Mastitis
was treated aggressively by using intravenous antibiotics, most commonly
cephalosporins. Though there were many factors related to breast infection, in this
series the possible contributory factors were fibrocystic disease (24.0%), lactation
(21.2%), nipple inversion (5.2%) and diabetes (4.7%). The exact cause was unknown
in nearly half (44.9%) of the patients, most of whom (78.8%) were non-lactational,
and only four patients were smokers, contrary to statements in many published
papers and textbooks. The predominant known causative agent was staphylococcus
aureus.
Conclusions: This study suggests that the early use of aggressive anti-staphylococcal
antibiotics may prevent mastitis from developing into abscess, and that timely
surgical drainage combined with antibiotics would decrease the lengthy recovery and
reduce the pain and suffering of the patients so affected. Skilled breast
ultrasonography is a very useful adjunct to needle aspiration in differentiating
clinical mastitis from abscess. |
