本文選題：漿細(xì)胞性乳腺炎　切入點(diǎn)：導(dǎo)管擴(kuò)張癥　出處：《鄭州大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：背景漿細(xì)胞性乳腺炎(plasma cell mastitis,PCM)是一種既可發(fā)生于非哺乳期又可發(fā)生于哺乳期的乳腺炎癥,常見于中青年女性。根據(jù)疾病不同階段的表現(xiàn),也被稱為導(dǎo)管擴(kuò)張癥(mammary duct ectasia,MDE)和導(dǎo)管周圍乳腺炎(periductal mastitis,PDM)。近年來,發(fā)病率有上升傾向,但PCM長期以來沒有規(guī)范的指南或共識,國內(nèi)治療很不規(guī)范,常與其他非哺乳期乳腺炎混為一談,造成PCM常遷延不愈,逐漸破壞患者乳房,嚴(yán)重?fù)p害患者的身心健康。目的本研究通過收集鄭州大學(xué)第三附屬醫(yī)院2015年1月至2016年12月的PCM住院治療患者,統(tǒng)計(jì)分析一般資料、臨床表現(xiàn)、實(shí)驗(yàn)室檢查,了解PCM的部分臨床特點(diǎn),為PCM的規(guī)范診治提供借鑒。資料與方法篩選從2015年1月至2016年12月在鄭州大學(xué)第三附屬醫(yī)院入院治療的漿細(xì)胞性乳腺炎患者72例作為實(shí)驗(yàn)組。另篩選同時(shí)期于鄭州大學(xué)第三附屬醫(yī)院乳腺二科就診的非PCM患者60例作為對照組。收集并描述資料,包括年齡、體重指數(shù)、哺乳史、哺乳障礙史、首次發(fā)病部位、臨床分期、乳頭內(nèi)陷、雌二醇、孕酮、催乳素,并對體重指數(shù)、哺乳史、哺乳障礙史、乳頭內(nèi)陷、雌二醇、孕酮、催乳素進(jìn)行組間比較。使用SPSS 21.0對資料進(jìn)行統(tǒng)計(jì)描述和分析,使用SPSS 21.0、WPS 2016、Graph Pad Prism 5作圖。結(jié)果1年齡72例PCM患者中,年齡的取值范圍為18~56(歲),平均年齡為35.65±7.735(歲)。四分位間距為(30.25,40.75)歲。2體重指數(shù)72例PCM患者中,BMI24kg/m2的有36例,24kg/m2≤BMI≤28kg/m2的有30例,BMI≥28kg/m2的有6例。BMI的平均值為24.39±4.52。3哺乳72例PCM患者中,69例(95.8%)有生育史。有哺乳史的為49例(68.1%),其中19例(26.4%)有哺乳障礙史,無哺乳史的為20例。4臨床表現(xiàn)72例PCM患者中,有66例為單側(cè)發(fā)病,另外6例為雙側(cè)發(fā)病。首發(fā)部位在乳頭乳暈區(qū)的為41例,占56.9%,首發(fā)在內(nèi)上象限的為7例,占9.7%,首發(fā)在內(nèi)下象限的為6例,占8.3%,首發(fā)在外下象限的為9例,占12.5%,首發(fā)在外上象限的為10例,占13.9%。72例的PCM患者中,溢液期有4例,腫塊期為14例,膿腫期為22例,竇道為32例。溢液期患者比例為5.56%,腫塊期患者比例為19.44%,膿腫期患者的比例為30.56%,竇道期患者的比例為44.44%。72例的PCM患者中,就診時(shí)伴有患側(cè)乳頭內(nèi)陷的患者為55例(73.4%),43例(59.7%)為先天性乳頭內(nèi)陷,12例(16.7%)為PCM導(dǎo)致的乳頭內(nèi)陷。5實(shí)驗(yàn)室檢查統(tǒng)計(jì)72例的PCM患者雌二醇、孕酮、催乳素,雌二醇平均值為186.06±70.28ng/L,孕酮平均值為9.86±5.12ug/L,催乳素平均值為32.50±14.07ug/L。6組間比較BMI:實(shí)驗(yàn)組和對照組有顯著差異(t’=3.275,df=129.648,P=0.001)。哺乳史:實(shí)驗(yàn)組與對照組差異無統(tǒng)計(jì)學(xué)意義(χ2=0.002,df=1,P=0.963)。哺乳障礙史:實(shí)驗(yàn)組與對照組的哺乳障礙史有顯著性差異(χ2=9.830,df=1,P=0.002)。先天性乳頭內(nèi)陷:實(shí)驗(yàn)組與對照組的差異有統(tǒng)計(jì)學(xué)意義(χ2=46.314,df=1,P=0.000),PCM患者具有更高的先天性乳頭內(nèi)陷發(fā)病率。性激素:PCM組的雌二醇水平高于對照組(t’=6.608,df=121.143,P=0.000);實(shí)驗(yàn)組和對照組的孕酮水平?jīng)]有顯著差異(t=0.376,df=130,P=0.707);實(shí)驗(yàn)組的催乳素水平高于對照組(t’=7.238,df=121.259,P=0.000)。結(jié)論1.超重或肥胖、哺乳障礙史、先天性乳頭內(nèi)陷、高水平的雌二醇和催乳素是PCM相對于其他乳腺疾病的臨床特點(diǎn)。2.由于PCM患者的雌二醇和催乳素水平較高,可試用抑制雌激素的內(nèi)分泌治療。
[Abstract]:The background of plasma cell mastitis (plasma cell, mastitis, PCM) is a kind of breast inflammation can occur in non lactating and can occur in lactation, common in young women. According to the different stages of the disease, also known as ductal ectasia (mammary duct, ectasia, MDE) and periductal mastitis (periductal mastitis, PDM). In recent years, the incidence rate is rising trend, but the PCM has not standardized guidelines or consensus, the domestic treatment is not standardized, and other non lactation mastitis caused by PCM is often confused, defer does not heal, gradually damage patients with breast, serious damage to physical and mental health of patients with treatment of patients. In the purpose of this study is through the collection of the Third Affiliated Hospital of Zhengzhou University from January 2015 to December 2016 PCM, statistical analysis of general data, clinical manifestation, laboratory examination, understanding PCM part of the clinical characteristics, diagnosis and treatment of PCM for the specification provided For reference. Materials and methods from January 2015 to December 2016, screening at the Third Affiliated Hospital of Zhengzhou University hospital treatment of patients with plasma cell mastitis in 72 cases as experimental group. The other phase of breast screening at the same time the Third Affiliated Hospital of Zhengzhou University two hospital 60 cases of non PCM patients as the control group. The collection and description of data, including age, body mass index. The history of lactation, lactation disorders, onset site, clinical stage, nipple, estradiol, progesterone, prolactin, and BMI, history of breastfeeding, breastfeeding disorders, nipple, estradiol, progesterone, prolactin were compared between the two groups. By using the data of SPSS 21 on the statistical description and analysis, the use of SPSS 21, WPS 2016, Graph Pad Prism 5 mapping. Results 1 cases of PCM patients in the age of 72, the range of age was 18~56 (year), the average age was 35.65 + 7.735 (four years old). The spacing for (30.25,40.75).2 body 閲嶆寚鏁，

本文編號：1573911