Clinical analysis of surgical treatment and postoperative efficacy in piriform sinus fistula with acute inflammatory period of children
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摘要: 目的 探讨在儿童先天性梨状窝瘘感染期，采用支撑喉镜下内镜辅助低温等离子梨状窝瘘口射频消融术联合颈部脓肿切开引流术的临床疗效。方法 对厦门市儿童医院耳鼻咽喉头颈外科2018年1月-2023年12月接受上述联合手术治疗的30例先天性梨状窝瘘感染期患儿的临床资料进行了回顾性分析。术后，患儿均进行了密切的阶段性随访，包括颈部彩超和电子喉镜检查，以评估治疗效果。结果 30例患儿均成功完成了手术，术后未出现咽瘘、吞咽困难或内瘘口周围及瘘管深部感染，颈侧脓肿的切排创面愈合良好。随访6个月~2年，无一例复发。结论 低温等离子射频消融术处理梨状窝内瘘口联合颈侧脓肿切开引流术在治疗儿童先天性梨状窝瘘感染中显示出创伤小、操作简单、安全有效且复发率低的优势。这一联合手术方法为儿童先天性梨状窝瘘的治疗提供了新的治疗途径。
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关键词:
- 低温等离子射频消融术 /
- 儿童 /
- 先天性梨状窝瘘 /
- 感染期
Abstract: Objective To discuss the clinical efficacy of low-temperature radiofrequency ablation assisted by endoscopy combined with resection and drainage of cervical abscess for the treatment of congenital pyriform sinus fistula (CPSF) in the acute inflammatory period of children.Methods Clinical data of 30 patients with CPSF in the acute inflammatory period who received low-temperature radiofrequency ablation assisted by endoscopy under laryngoscope, combined with resection and drainage of cervical abscess, from January 2018 to December 2023 were reviewed. After the operation, patients were followed up closely at different stages. All patients underwent color Doppler ultrasound and electronic laryngoscopy, and the results were analyzed.Results All 30 children successfully completed the surgery without pharyngeal fistula, dysphagia, perifistula, or distal fistula infection, and the incision in the neck healed well. The follow-up survey ranged from 6 months to 2 years, and no recurrences were observed.Conclusion Low-temperature radiofrequency ablation assisted by endoscopy combined with resection and drainage of cervical abscess is a promising method for treating CPSF in the acute inflammatory period. It is less traumatic, simple, safe, has a significant curative effect, and a low recurrence rate. This approach can be used as a supplementary operation for CPSF in children and provides a new way for clinical treatment. -
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表 1 5例典型患儿术前基本信息
例序 性别 年龄 主诉及病程 脓肿大小/cm3 伴随症状 既往颈部感染病史 瘘管位置 1 男 11岁4个月 左颈肿痛4 d 3×3 无发热 无 左侧 2 男 6岁7个月 左颈肿痛3 d 2×2 有发热，体温最高39.0℃ 反复左颈肿痛3年，行脓肿切开3次 左侧 3 女 4岁6个月 左颈肿痛7 d 3×2 有发热，体温最高39.0℃ 反复左颈肿痛5个月 左侧 4 女 2岁5个月 右颈肿痛10 d 4×3 无发热 无 右侧 5 女 6岁9个月 左侧颈部肿痛4 d 2×1 有发热，体温最高38.2℃ 无 左侧 
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