中国实用外科杂志

中国实用外科杂志

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非哺乳期乳腺炎临床特征及危险因素分析

刘    璐，周    飞，于理想，马忠兵，傅勤烨，高德宗，张    强，李    亮，王    斐，余之刚   

  1. 山东大学第二医院乳腺外科,山东济南 250033
  • 出版日期:2016-07-01 发布日期:2016-06-23

  • Online:2016-07-01 Published:2016-06-23

摘要：

目的    探讨非哺乳期乳腺炎（NPM）的临床特征及发病危险因素。方法    回顾性分析2011年1月至2015年3月山东大学第二医院乳腺外科经病理学检查确诊的NPM病人120例（病例组）资料，选取山东大学第二医院查体中心的健康人群111名作为对照组。比较两组病人临床特征，并进行单因素及多因素分析。结果    病例组病人年龄为33（20～62）岁，病变常见于乳腺外上象限（21.7%）、内上象限（20.0%）及乳头乳晕区（30.8%），临床分型以肿块型（45.8%）为主。两组在超重/肥胖、生育次数、初育年龄、哺乳时间、初潮年龄、乳头内陷、既往哺乳史方面比较差异有统计学意义（P<0.05）。多因素分析显示生育次数（OR=5.02，95%CI 1.06～23.86，P=0.042）、初潮年龄（OR=1.97，95%CI 1.45～2.68，P＜0.001）及超重/肥胖（OR=1.25，95%CI 1.08～1.44，P=0.002）为NPM的危险因素，而初育年龄（OR=0.85，95%CI 0.74～0.98，P=0.025）为该病的保护因素。结论    NPM有其特定临床特征，生育次数多、初潮年龄晚、超重/肥胖可增加该病发病风险，初育年龄晚可降低该病的发病风险。

关键词: 乳腺, 非哺乳期乳腺炎, 乳腺导管扩张症, 导管周围乳腺炎, 肉芽肿性小叶性乳腺炎, 危险因素

Abstract:

An analysis of clinical characteristics and risk factors for non-puerperal mastitis        LIU Lu, ZHOU Fei, YU Li-xiang, et al. Department of Breast Surgery, the Second Hospital of Shandong University, Jinan 250033,China
Corresponding author: YU Zhi-gang, E-mail:yzg@medmail.com.cn
Abstract    Objective    To investigate the clinical characteristics and risk factors for non-puerperal mastitis (NPM). Methods    The clinical and pathological data of 120 resident patients between January 2011 and March 2015 in Department of Breast Surgery, the Second Hospital of Shandong University were collected and analyzed retrospectively, while 111 healthy controls were included in the non-matched case-control study. Epidemiological and clinicopathological features were recorded and etiologic factors were obtained by comparing case and control group information using univariate and multivariable analysis. Results    The median age of patients was 33 (range from 20 to 62) years. The lesions often located in the upper outer quadrant(21.7%), upper inner quadrant(20.0%) and the subareolar area(30.8%) of the breast, and the most common clinical type was mass-type(45.8%). There were significant differences between two groups in the aspect of overweight/obesity, age at menarche, number of full-term pregnancies, early age at first full-term pregnancy, long duration of breastfeeding, history of breastfeeding and nipple retraction. Multivariable logistic analysis showed overweight/obesity (OR=1.25, 95%CI 1.08—1.44, P=0.002), number of full-term pregnancies (OR=5.02, 95%CI 1.06—23.86, P=0.042) and age at menarche (OR=1.97, 95%CI 1.45—2.68, P＜0.001) as independent risk factors for NPM, age at first full-term pregnancy(OR=0.85, 95%CI 0.74—0.98, P=0.025) as a protective factor. Conclusion    Overweight/obesity, times of bearing birth and age at menarche are associated with NPM. Late first full-term pregnancy can minimize the modifiable risks.

Key words: breast, non-puerperal mastitis, mammary duct ectasia, periductal mastitis, granulomatous lobular mastitis, risk factor