目的 探讨腔镜深筋膜下交通支离断术（subfascial endoscopic perforating vein surgery，SEPS）治疗下肢静脉性溃疡的效果及优势。方法 对苏州大学附属第一医院2006年12月至2008年5月期间收治的30例下肢静脉性溃疡患者（32条患肢）实施SEPS。术后观察溃疡的愈合情况及其他症状的改善情况。结果 全组随访3～15个月（平均8.5个月），静脉性溃疡于术后27～103 d(平均65 d)内愈合，湿疹消失，色素沉着逐渐变浅； 随访期间无切口感染等并发症，未见溃疡复发及新生溃疡。结论 SEPS安全有效，损伤小，并发症少，是治疗下肢静脉性溃疡较为有效的方法。
ObjectiveTo summarize the clinical characteristics of idiopathic granulomatous mastitis (IGM) and its experiences of diagnosis and treatment. MethodThe clinical data of 33 patients with IGM from January 2005 to December 2014 were analyzed retrospectively. ResultsThe mean age of the patients was 33 years. The pathological examination showed that 28 patients (85%) were typical granuloma, and 5 patients (15%) were immature granuloma, whom were confirmed after exclusion of other pathogens. Twenty-nine patients were received drugs treatment, among which 21 patients were cured by taking prednisone orally, 6 patients were cured by the combination of prednisone and methotrexate, 2 patients failed to be cured, and 13 patients relapsed after stopping taking medicine. Four patients with abscess ulceration were received surgical treatment, and 2 patients relapsed after the surgery. Fifteen recurrent patients all were took prednisone and methotrexate orally, among which 1 patient stopped taking medicine because of liver function damage, 1 patient was not fully relieved, and other 13 patients were cured again. ConclusionsThe clinical manifestations of IGM have no specificities. The diagnosis mainly relies on pathological examination. In the early phase of this disease, the treatment method of steroid or combined immunosuppressant has good effects. In case of ulceration and protracted course, surgical treatment should be considered as early as possible.