Objective To observe and evaluate the efficacy of continuous drainage with intravenous catheter in the treatment of breast abscess infected by methicillin resistant staphylococcus aureus (MRSA) and to explore the best treatment methods. Methods Sixty cases of breast abscess infected by MRSA were retrospectively analyzed. The patients were divided into continuous drainage group and puncture drainage group according to the treatment. Continuous drainage with 14G intravenous catheter and intermittent aspiration with 20 mL syringe were performed to treat the breast abscesses in the continuous drainage group (n=36) and puncture drainage group (n=24), respectively. Meanwhile, sensitive antibiotics were used according to the results of susceptibility test. The therapeutic effects of the 2 groups were compared. Results There were no significant differences in baseline data between continuous drainage group and puncture drainage group (P>0.05). There was no significant differences of cure rate between the two groups (P=0.717). Compared with the puncture drainage group, the continuous drainage group showed shorter period of time to heal the breast abscess (P=0.001), shorter period of time to control the ache (P=0.038), less punctures (P<0.001) and more daily volume of drainage (P<0.001). No significant differences were found in the period of time to control the fever between the two groups (P=0.127). Conclusions Continuous drainage with intravenous catheter can shorten the course of disease, reduce the suffering of patients, reduce the difficulty of hospital infection prevention and control. It’s an ideal choice for the treatment of breast abscess infected by MRSA.
Abstract： Objective To compare clinical outcomes and postoperative quality of life （QOL） of difference surgical strategies for patients with esophagogastric junction （EGJ） cancer， and investigate the best surgical strategy. Methods A total of 148 patients with EGJ cancer underwent surgical treatment in Xuzhou First People’s Hospital from July 2007 to October 2011. There were 111 male patients and 37 female patients with an average age of 64 （47-77）years. All the patients were divided into 3 groups according to different surgical strategies for them based on their respective preoperative assessment and tumor invasion degree. In group A， 81 patients underwent proximal subtotal gastrectomy and subaortic gastroesophageal anastomosis. In group B， 20 patients underwent total gastrectomy and esophagojejunostomy. In group C， 47 patients underwent proximal subtotal gastrectomy and jejunal interposition. Postoperative mortality and morbidity were compared among the three groups. Cancer metastasis rate and 1-year survival rate were also compared among the three groups. QOL questionnaire （EORTC QLQ C-30 and tumor specific module QLQ-OES24） was used to evaluate patients’ QOL during follow-up. Results There was no statistical difference in postoperative morbidity （P=0.762）and mortality （P=0.650）among the three groups. There was no statistical difference in cancer metastasis rate at 1 year after surgery among the three groups （P=0.983）. One-year survival rate was 100% in all the three groups. At 1 year after surgery， physical functioning score （P=0.037，0.000） and global health score （P=0.035，0.006） of group A and group C were significantly higher than those of group B， and there was no statistical difference in physical functioning score and global health score between group A and group C （P＞0.05）. Emotional function score of group B was significantly lower than that of group C （P=0.015）. Fatigue score （P=0.040，0.006）， anorexia（P=0.045，0.025）， nausea and vomiting symptom score （P=0.033，0.048） of group A and group C were significantly lower than those of group B. Pain score of group A was significantly lower than that of group C （P=0.009）. Insomnia score of group A was significantly higher than that of group C （P=0.028）. Reflux score of group A was significantly higher than that of group B and group C （P=0.025，P=0.021）. Conclusion Postoperative QOL in patients with EGJ cancer who undergo total gastrectomy is comparatively unsatisfactory. Proximal subtotal gastrectomy and jejunal interposition can significantly improve postoperative QOL. Postoperative QOL evaluation is helpful to choose better surgical strategies for patients with EGJ cancer.