Clinical Study On The Treatment Of Lactation Mammary Abscess By Minimally Invasive Rotary Resection

Objective:Prospective analysis of the efficacy of minimally invasive rotary incision plus catheter drainage and puncture and pus extraction on lactational mammary abscess,and comprehensively compare and analyze the advantages and disadvantages of the two treatment schemes through relevant objective indicators.Provides the best treatment.Research methods:A prospective analysis was performed on the data of 80 patients suffered from lactational mammary abscess from the outpatient department of Tianjin Central Hospital Of Gynecology Obstetrics from January 2019 to January 2020.According to the wishes of the patients,the above patients were divided into a minimally invasive rotary incision plus catheter drainage group and a needle aspiration with ultrasound guidance group.Finally,30 patients were included in the minimally invasive rotary incision plus catheter drainage group,and 50 patients were included in the needle aspiration with ultrasound guidance group.We recorded the patient’s preoperative data including name,age,parity,preoperative body temperature,postpartum time,whether the skin is ulcerated,pus cavity generation time,maximum diameter of the pus cavity,and location of the pus cavity.Intraoperative data includes the characteristics of the drainage fluid,drainage Flow rate,surgical incision length,intraoperative bleeding volume,cumulative bleeding volume,intraoperative pain score,cumulative pain score.Postoperative data includes postoperative body temperature,pus culture results,drainage time,rehabilitation time,and total drainage volume(intraoperative drainage volume plus postoperative drainage volume),whether to continue breastfeeding,whether to continue breastfeeding,recurrence rate,patient satisfaction,postoperative scar length,incidence of adverse events,total patient expenditure,etc.Follow-up methods are outpatient follow-up and telephone follow-up.Finally,the relevant data are comprehensively analyzed.Result:1.Preoperative data: minimally invasive rotary incision plus tube drainage group(hereinafter referred to as minimally invasive group): 30 patients were included,there were 5 cases(5/30)of central pus.needle aspiration with ultrasound guidance group(hereinafter referred to as aspiration group): 50 patients were included,there were 8cases(8/50)of central pus.There were no statistically significant differences between the two groups in age,parity,preoperative body temperature,postpartum time,skin ulceration,pus cavity generation time,pus cavity size and pus cavity location(P>0.05).2.Intraoperative data: minimally invasive group: the drainage fluid is yellow-white to pink and rufous purulent secretions,that is a mixture of milk and pus.Aspiration group: The suction fluid during operation was yellow-white to off-white purulent secretions,and the characteristics of each suction were similar.During the comprehensive comparison,there were statistical differences between the two groups in drainage volume,intraoperative blood loss,intraoperative pain score,and cumulative pain score(P <0.05),but there was no statistical difference in cumulative blood loss(P> 0.05).When the diameter of the pus cavity is ≤5cm.There was a statistical difference between the drainage volume,intraoperative bleeding volume,cumulative bleeding volume,intraoperative pain score and cumulative pain score of the two groups(P <0.05).There weas a statistical differences between the two groups in drainage volume,intraoperative pain score,cumulative pain score,and cumulative bleeding volume(P <0.05).3.Postoperative data: minimally invasive group: postoperative body temperature:36.30 ～ 38.30(mean 37.13 ± 0.58)℃.Pus bacterial culture results: 25 patients developed Staphylococcus aureus,and 5 patients did not see bacterial growth.Aspiration group: Postoperative body temperature: 36.30 ～ 39.20(mean 37.21 ±0.79)℃,postoperative pus culture results: 38 patients developed Staphylococcus aureus,3 patients developed surface Staphylococcus,9 patients did not see bacteria Grow.Postoperative body temperature decreased in both groups compared with before operation,and the drainage characteristics in the minimally invasive group was mostly a mixture of milk and pus.The pus group sucked up pus with each puncture.In a comprehensive comparison,there was a statistical difference between the two groups in terms of drainage time,recovery time,patient satisfaction score,and patient cost(P <0.05).The total amount of postoperative drainage,whether to continue breastfeeding,whether to relapse,whether to have There was no statistical difference between adverse reactions and lack of milk(P> 0.05).When the pus cavity is less than or equal to 5 cm,there is a statistical difference between the two groups of patients’ satisfaction(P <0.05),and the remaining indicators are not statistically different;when the pus cavity is> 5 cm,the drainage time,recovery time,and satisfaction between the two groups There was a statistical difference between the degree scores(P <0.05),and other indicators had no statistical difference(P> 0.05).Conclusion:Minimally invasive rotary incision plus tube drainage is generally better than puncture and purulent aspiration,less pain during surgery,more thorough drainage after surgery,and good cosmetic results;but when the patient’s pus cavity is smaller(diameter≤5cm),and superficial abscess,minimally invasive rotary incision plus drainage of the tube is not better than puncture and abscess.When the patient has a large abscess(> 5cm)and multiple abscesses or deep large abscesses,The effect of minimally invasive rotary incision plus tube drainage is more preferred;it does not affect the breastfeeding function during treatment;but minimally invasive rotary incision is more expensive.When selecting the treatment,it is necessary to integrate the patient’s condition and the patient’s personal wishes to select the appropriate patient efficacy method.