[outline] Occurs in post-natal, overwhelming majority for at the beginning of parturient woman. Many in staphylococcosis. Because of galactophore blocking, the milk siltation, the bacterium direct invasion result, or the bacterium chaps place the invasion galactophore from the nipple or the areola and infects along the lymph drainage drive pipe mammary gland small leaf.
[diagnosis]
1. has the nipple wound or the nipple maldevelopment history, starts to have feels cold, then the high fever, the shiver, the headache, the breast painfully swollen or the putsation ache.
2. early breast swelling, partial induration, then red, swells, the heat, the tenderness; Forms abscess to have the wave person or household who refuses to move and bargains for unreasonably high compensation when the land is requisitioned for a construction project, infection table shallow may voluntarily broken kui; Contracts the side armpit lymph to be tumescent, tenderness.
3. the systemic reaction has a poor appetite, rise of bodily temperature, the shiver, but concurrent septicaemia.
4. the auxiliary inspection white blood cell total and the neutral granular cell obviously elevate.
[remedial measure]
1. the early injection rest, suspends trouble side breast nursing, the clean nipple, the areola, the promotion milk excretion (with breast pump or suction), every must cut open the drainage to terminate nursing.
2. partial uses 25% magnesium sulfate wet hot compress, the physical therapy.
3. the early time may use penicillin 800,000 ~ 1,000,000 U to add 1%~2% Procaine 10ml to dissolve in isotonic salt solution 10~20ml, seals up the injection around the tumour.
4. whole body application antibiotic. For the prevention serious infection and the septicaemia, selects the antibiotic sensitively according to the bacilliculture and the medicine, when the necessity the vein drop note antibiotic.
5. traditional Chinese medicine refrigeration antidote.
6. abscess has formed should cut open the drainage promptly, the margin take the nipple, the areola assumes generally as the center radially, under the areola the shallow abscess may makes the arc incision along the areola, abscess after the breast, should lower part the breast the skin wrinkle 1~2 centimeters make the arc incision.
[etiology]
Besides time post-natal whole body anti-infection ability drop, has the following two aspect reason:
1. the milk siltation milk siltation is advantageous in invades into bacterium’s growth reproduction. The siltation reason includes:?The nipple maldevelopment (too small or in falls) hinders nursing;?The milk are excessively many or the baby attracts the breast to be few, so that the milk cannot evacuate completely;?The galactophore cannot, affect a row of breast.
2. the cell invasion nipple breakage causes the bacterium along the lymph vessel invasion is the infection main way. The baby mouth yan rests or the baby including the nipple contracts stomatitis to be also advantageous to the bacterium direct invasion galactophore. Pathogenic bacteria by golden yellow grape fungus primarily.
[clinical manifestation]
Gets up gets sick often has the high fever, to tremble and so on whole body symptoms of poisoning, contracts the side breast volume to increase, stiffens partially, the skin blushes, has the tenderness and the putsation ache. If in the short-term changes soft partially, explained already has abscess to form, needs to cut open the drainage. Contracts the side common the armpit lymph node tumescent, white blood cell counting markup.
Abscess’s clinical manifestation with its position depth related, when the position is shallow, the early time has partial inflamed, sticks out, but time depth portion abscess early time the partial performance is not often obvious, by local pain and body-wide symptom primarily. Abscess may single or many; May successively or also forms; Sometimes voluntarily broken kui or discharges after the nipple, after may also invade the mammary gland, in the gap Open texture, after forming the mammary gland, abscess. (Figure 1).
Figure 1 mammary abscess’s position
[prevention]
Mastitis’s prevention treat to importantly. Must maintain both sides nipple’s clean in the gestation period and the breast-feeding period, if has in the nipple shrinking, after should squeeze out gently the nipple, cleans cleanly. Around nursing available 3% boric acid laundering only nipple. Forms habit which fixed time nurses, each time nurses when should attract the milk only, cannot attract only when may massage usefully squeezes out or uses the breast pump aspiration. When the nipple had the breakage or chaps, should temporarily nurse, with the breast pump aspiration milk, after waiting the wound to heal, nurses again.
