澄清急性无并发性儿科乳腺炎的诊断和管理
Antoinette R Esce1, Samantha A Trujillo1, Karen A Hawley1
1Department of Surgery, Division of Otolaryngology Head and Neck Surgery, University of New Mexico, Albuquerque, NM, USA.
The Annals of otology, rhinology, and laryngology
|June 14, 2024
概括
不复杂的儿科乳腺炎的精细定义,不包括骨质侵蚀,识别了更多需要保守治疗的患者. 这种方法减少了乳腺切除术率和长期使用抗生素的儿童耳部感染.
科学领域:
- 耳鼻喉科 耳鼻喉科 耳鼻喉科
- 儿童传染病 儿童传染病
- 医学诊断 医学诊断 医学诊断
背景情况:
- 急性儿科乳腺炎是一种细菌感染,通常与急性中耳炎有关,具有诊断挑战.
- 医学文献中存在复杂与无复杂乳腺炎的不一致定义.
- 目前的管理策略范围从复杂病例的手术干预到不复杂病例的潜在医疗管理.
研究的目的:
- 为了澄清不复杂的急性儿科乳腺炎的诊断标准.
- 评估不同定义对患者分类和治疗的影响.
- 确定儿科乳腺炎的最佳管理途径.
主要方法:
- 在一个机构16年来对80例儿科乳腺炎病例进行了回顾性审查.
- 对无并发性乳腺炎的两种定义进行比较:传统的 (不包括内并发症或骨下) 和建议的 (另外不包括骨质侵蚀/凝结).
- 单变量和多变量分析,以评估定义,治疗和结果之间的关联.
主要成果:
- 与传统定义 (46.3%) 相比,提出的定义将较少的病例归类为不复杂 (36.2%).
- 根据拟议的定义分类的患者接受了更一致的,保守的管理,没有乳腺切除术和更少的长期抗生素处方.
- 多变量分析证实,拟议的定义与减少长期抗生素治疗和非手术管理独立相关.
结论:
- 无并发性急性乳腺炎应根据临床标准定义,排除任何骨质侵蚀,包括凝结或骨下.
- 符合这些精细标准的无并发性乳腺炎患者可能不需要乳腺切除术,并且可以从较短的抗生素疗程中受益.
- 需要进一步的研究,以优化无并发性急性儿科乳腺炎的治疗方案.
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