Analysis Of Influence Factors Of Granulomatous Lobular Mastitis And Discussing Individualized Comprehensive Diagnosis And Treatment Of This Disease

Objective:Retrospective analysis about the influenced factors and the effect of classified treatment of 135 cases granulomatous lobular mastitis.Methods:A retrospective analysis of 135 cases of GLM which admitted from Hunan People’s Hospital was conducted from April 1,2014 to December 31,2017.According to the different course of GLM,it was divided into three groups:The possible clinical factors such as the age of GLM,the time of hospitalization,the use of sex hormone,the hyperprolactinemia and the lactation of the affected side were analyzed.All cases were confirmed by glucocorticoid plus Chinese patent medicine.According to the lump type and abscess type,different comprehensive treatment methods were adopted respectively.The simple mass type GLM takes the drugs of methylprednisolone combined with the western yellow capsule,or the Chinese medicine doctor to open the Chinese herbal medicine and the local Magnesium Sulfate wet hot compress,and after the lump is obviously reduced,the surgical treatment is taken.The mass with the abscess type of GLM is first carried out(a variety of drainage methods,the best choice for small trauma method),combined antibiotics.At the same time,according to the first type of treatment,after the lesion is reduced by 1～2cm,surgical treatment is optional.All the patients were evaluated by the special medical examination,color doppler ultrasound plus or without MRI.Results:1.There is a correlation between the different course of GLM and the duration of hospitalization and high prolactinemia(P<0.05),and there is no correlation with the age of onset,the use of sex hormone,and the lactation disorder of the affected side(P>0.05).2.GLM was treated with corticosteroid and Chinese traditional medicine.According to the progress of the disease,different surgical methods were adopted,respectively:105 cases of lump type were treated with debridement+I stage reconstructive surgery,the cure rate was 97.1%,the recurrence rate was 2.9%.The focus spread of 4 cases,combined with the patient’s wishes,treated with preservation of nipple areola complex subcutaneous gland complete resection and focal debridement,the cure rate of was 100%and the recurrence rate was 0.26 cases of abscess type which was performed by drainage and of breast incision +Ⅱ stage reconstructive surgery the rate of cure was 100%and the recurrence rate was 0.Conclusion:1.The GLM correlation between three groups was correlated with the duration of hospitalization and hyperprolactinemia,and the correlation between the age of the three groups,the use of sex hormone,the lactation disorder of the affected side and the course of the three groups could not be obtained.2.Before operation,glucocorticoid combined with Chinese medicine was used to treat GLM,and different surgical treatment methods were selected according to the classification of diseases after treatment.Debridement combined with glandular transposition was a safe and effective treatment to improve the cure rate of GM and reduce the injury of breast shape.It is the best time to control the acute inflammation stage or reduce the lesion obviously.