Abstract: 【Abstract】〓Objective〓To introduce the diagnosis and treatment of refractory idiopathic granulomatous mastitis (IGM) and related literature review. Methods〓Three patients were complained of breast lump with redness and local ulceration even fistula formation. The pus bacteria culture were all negative...Two patients were given systemic therapy with corticosteroids and ‘Triple-anti mycobacterial therapy'. One case was treated with methyl prednisolone combined with methotrexate. Results〓There was no recurrence in follow-up for ten months. One case finally underwent wide excision and nipple retraction diorthosis and cured. The other two were both cured by conservative treatment. Conclusion〓‘Triple-anti mycobacterial therapy' or immunosuppressive agent combined with steroid therapy were effective approach for refractory IGM, but it was difficult and debatable to obtain the former medical evidence.

Key words: Granulomatous mastitis, Corticosteroid, Immunosuppressive, Mycobacteria, Reflapse　

摘要： 【摘要】〓目的〓介绍三例难治性特发性肉芽肿性乳腺炎(IGM)的诊治经过及治疗效果并文献综述。方法〓三例难治性IGM患者均为年轻生育后女性,均因乳房肿块伴红肿及局部破溃甚至窦道形成等弥漫病变就诊,脓液细菌培养阴性,其中2例患者应用“三联抗分支杆菌”药物联合甲泼尼龙片治疗,1例患者接受甲泼尼龙联合甲氨蝶呤治疗。结果〓三例患者均得到10个月随访,1例接受“三联抗分支杆菌”药物及甲泼尼龙的患者最终行肿块切除及乳头内陷矫正术后痊愈,其他2例患者均保守治疗后痊愈。结论〓“三联抗分支杆菌”或免疫抑制剂联合类固醇激素治疗难治性特发性肉芽肿性乳腺炎的效果良好,但前者用药证据较难获得。

关键词: 复发, 肉芽肿性乳腺炎, 激素, 免疫抑制, 分支杆菌