| Objective:Non-puerperal mastitis(NPM)is a benign disease,which has the characteristics of long course,various pathological types,affecting patients' quality of life after operation and high recurrence rate.The purpose of this study was to distinguish two common pathological types of non-puerperal mastitis(periductal mastitis(PDM)and granulomatous mastitis(GM)),through prospective clinical trials.To explore the therapeutic effect of different interventions on non-puerperal mastitis.It is expected to provide reliable basis for diagnosis and treatment of NPM in the future.Methods:From September 2017 to September 2019,99 patients with non-puerperal mastitis were admitted to the Department of gland surgery of the first Hospital of Shanxi Medical University.The general clinical data were collected,the breast lesions were examined by puncture,the puncture tissue was tested by Polymerase Chain Reaction(PCR)of mycobacteria,and the pus of patients were sent to bacterial culture.50% magnesium sulfate solution continuous wet compress or Ruyi golden powder several times a day were given to patients at random,surgical treatment after localized lesions.To observe the treatment effects of patients and the changes of postoperative conditions.The data were analyzed by SPSS22.0 statistical software.The counting data were expressed by rate(%),the average age was tested by independent sample t-test,and the age distribution,focus location,nipple development,first clinical stage and clinical efficacy were compared by chi-square test.Results:Among the 99 patients,there were 66 cases of periductal mastitis and 33 cases of granulomatous mastitis.Through the independent sample t-test of the two groups,there was a significant difference in the average age of onset between the two groups(t = 2.020,p < 0.05).66.67%(44/66)of the lesions were located within the areola 2cm in the PDM group.69.70%(23/33)outside the areola 2cm in the GM group,and there was a statistically significant difference between the two groups(c2=11.733,P < 0.001).External application of 50% magnesium sulfate or Ruyi Gold Powder at the first visit.After interventiontreatment,2 patients(2.02%)were cured,28 patients(28.28%)were significantly effective,53 patients(53.54%)were effective,16 patients(16.16%)were ineffective or progressed,and the total effective rate was 83.84%.59 cases(89.39%)were effective in PDM group and 24 cases(72.72%)were effective in GM group.There was significant difference between the two groups(c 2=4.510,P < 0.05).In the comparison of 56 cases of 50%magnesium sulfate and 43 cases of Ruyi gold powder,there was no statistical difference between the two groups(c2=0.001,p > 0.05).In magnesium sulfate group,39 patients with PDM(92.86%)were effective,and 8 patients with GM(57.14%)were effective.The difference between the two groups was statistically significant(c2=7.458,P < 0.05).The uncured patients were treated by operation,and 20 cases(20.20%)were found to have ipsilateral or contralateral recurrence or postoperative infection in the follow-up.Conclusion:From the analysis of clinical data,the average age of the onset in patients with PDM is lower than that in patients with GM.PDM patients can be seen in any age group,and the incidence of GM is generally in parturients.In patients with PDM,the focus is closer to the nipple,while in patients with GM,the focus is often located outside the areola,and both are common in the mass stage.50% magnesium sulfate or Ruyi gold powder is effective and similar in the treatment of nonpuerperal mastitis;and 50% magnesium sulfate is more effective in periductal mastitis.Preoperative intervention in the treatment of nonpuerperal mastitis can reduce the scope of operation,which can improve patients' aesthetic requirements and provide important reference for clinical practice. |
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