儿童急性乳腺炎的管理:一个回顾性分析
Marella Reale1, Carlotta Montagnani2, Pietro Orlando3
1Otorhinolaryngology Unit, Head and Neck Department, Meyer Children's Hospital IRCCS, Florence, Italy.
Italian journal of pediatrics
|September 24, 2025
概括
急性乳腺炎 (AM) 和复杂的AM (CAM) 是严重的耳部感染并发症. 升高的CRP水平表明CAM风险更高,而大多数AM病例是通过医疗治疗的,而CAM通常需要手术.
科学领域:
- 儿科耳鼻喉科 儿科耳鼻喉科
- 传染性疾病 传染性疾病
背景情况:
- 急性乳腺炎 (AM) 是急性中耳炎 (AOM) 的常见并发症.
- 在AM的诊断或治疗管理方面没有确立的共识.
- 如果不及时诊断和治疗,AM会导致严重的并发症.
研究的目的:
- 分析患有AM和复杂AM (CAM) 的儿童的管理.
- 评估AM和CAM之间临床表现和管理的差异.
- 概述AM和CAM的潜在诊断和治疗途径.
- 为了评估 AM 的发生率随着时间的推移.
主要方法:
- 对接受AM或CAM治疗的儿科患者进行了回顾性研究.
- 从2016年1月到2023年12月在佛罗伦萨梅耶大学医院-IRCCS收集的数据.
- 对临床表现,微生物学发现,管理和结果的分析.
主要成果:
- 包括85名患者 (60%是男性,中位数年龄为4岁).
- Pseudomonas aeruginosa 是AM中最常见的病原体,在CAM中是Streptococcus pyogenes.
- 17名患者发生了CAM;高CRP水平与CAM风险增加有关 (p=0.043).
- 亚米治疗主要是医疗 (输液抗生素);手术很少 (1/68).
- 在CAM管理中,经常需要手术 (76%),通常是带有液排水的乳腺切除术.
- 在研究期间观察到AM病例的显著增加,特别是在2023年.
结论:
- AM和CAM是罕见的,但可能危及生命的AOM并发症.
- 2023年AM病例的增加可能与解除流行病限制有关.
- 乳腺炎的治疗是异质的,甚至在一个机构内.
- 升高的CRP是复杂的乳腺炎的唯一确定的预测因子.
- 需要指导方针来支持AM和CAM的及时诊断和有效管理.
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