摘要
目的探讨个体化术式选择治疗儿童梨状窝瘘的效果。方法选取2015年6月至2019年11月河南省人民医院小儿外科收治的43例梨状窝瘘患儿,左侧41例,右侧2例;炎症控制期27例,急性炎症期16例;根据个体病情选择低温等离子射频消融、梨状窝瘘切除、颈部脓肿切开引流等术式或联合术式,观察术后并发症及复发情况。结果43例梨状窝瘘患儿中,19例行低温等离子射频消融术,11例行低温等离子射频消融术+颈部脓肿切开引流术,5例行低温等离子射频消融术+梨状窝瘘切除术,8例行梨状窝瘘切除术。术后4例出现声音嘶哑,随访1~5个月恢复;1例出现颈部脓肿切开引流术后假性愈合,予切开清创后愈合。4例复发,随访时间3~57个月。结论低温等离子射频消融治疗具有微创、安全、有效等优点,为儿童梨状窝瘘提供新的治疗方法,根据患儿病情选择个体化治疗方案能够显著提高疗效。
Objective To explore the curative effects of individualized surgical method for treating pyriform sinus fistula(PSF)in children.Methods A total of 43 PSF children treated in the Department of Pediatric Surgery of Henan Provincial People′s Hospital from June 2015 to November 2019 were selected,with 41 cases on the left side and 2 cases on the right side.There were 27 cases in the quiescent inflammatory infection stage and 16 cases in the acute inflammatory infection stage.According to patients′condition,low-temperature plasma radiofrequency ablation,fistulectomy,abscess incision and drainage or combined operation were conducted.The postoperative complications and recurrence were observed.Results Among 43 cases,there were 19 cases treated with low-temperature plasma radiofrequency ablation,11 cases treated with low-temperature plasma radiofrequency ablation combined with abscess incision and drainage,5 cases treated with low-temperature plasma radiofrequency ablation combined with fistulectomy,and 8 cases treated with fistulectomy.Four cases had postoperative hoarseness and recovered within 1-5 months.One case occurred pseudo healing after abscess incision and drainage,and healed after incision and debridement.Totally,4 cases recurred,and the follow-up time was from 3 months to 57 months.Conclusions Low-temperature plasma radiofrequency ablation has the advantages of minimally invasive,safe and effective,which provides a new treatment for PSF in children.Based on the condition of children,the choice of individualized treatment can significantly improve the curative effects.
作者
鲍俊涛
孙占伟
张书峰
杨凯骅
秦璐莹
Bao Juntao;Sun Zhanwei;Zhang Shufeng;Yang Kaihua;Qin Luying(Department of Pediatric Surgery,Henan Provincial People′s Hospital,Zhengzhou 450003,China;Department of Otorhi-nolaryngology Head and Neck Surgery,Henan Provincial People′s Hospital,Zhengzhou 450003,China;School of Nursing and Health,Zhengzhou University,Zhengzhou 450001,China)
出处
《中华实用儿科临床杂志》
CAS
CSCD
北大核心
2021年第11期836-839,共4页
Chinese Journal of Applied Clinical Pediatrics
基金
河南省医学科技攻关计划项目 (201602172)。
关键词
梨状窝瘘
低温等离子射频消融
儿童
Pyriform sinus fistula
Low-temperature plasma radiofrequency ablation
Child
