鳃裂囊肿(瘘)284例临床分析  

Clinical analysis of branchial cleft cyst(fistula):report of 284 cases

作　　者：胡永杰[1] 李亚东[2] 曲行舟[1] 王丽珍[3] 钟来平[1] 刘浏[1] 张陈平[1] 

机构地区：[1]上海交通大学医学院附属第九人民医院·口腔医学院口腔颌面外科,上海市口腔医学研究所·上海市口腔医学重点实验室,上海200011 [2]河南省人民医院口腔科,河南郑州450003 [3]上海交通大学医学院附属第九人民医院·口腔医学院口腔病理科,上海200011

出　　处：《上海口腔医学》2008年第5期461-464,共4页Shanghai Journal of Stomatology

基　　金：上海市重点(优势)学科建设项目(Y0203)~~

摘　　要：目的:总结284例先天性鳃裂囊肿(瘘)病例资料,对其诊断和治疗方法进行探讨。方法:回顾分析1993年6月至2006年12月手术治疗的284例鳃裂囊肿(瘘)的临床资料,包括术前检查、术前诊断和术后病理,随访时间最短6个月,最长120个月,平均37个月。采用SAS6.12软件包对数据进行统计学分析。结果:所有病例均经病理证实为鳃裂囊肿(瘘),其中第一鳃裂囊肿132例,占46.5%;第二鳃裂囊肿145例,占51.1%;第三鳃裂囊肿7例,占2.4%。第一鳃裂囊肿好发于40岁后的中老年,第二、三鳃裂囊肿好发于40岁前的青壮年。术后病理证实原发病变188例,复发病变33例,囊肿伴内瘘44例,囊肿继发感染伴外瘘16例,内、外瘘均有为3例。鳃裂囊肿(瘘)伴结核1例,多囊性囊肿2例,伴静脉畸形1例,恶性变6例(5例来源于第一鳃裂囊肿,1例来源于第二鳃裂囊肿)。术前辅助检查中,B超检查的诊断符合率最高,为66.20%。随访期间,鳃裂囊肿复发率为5.98%。结论:第一、二鳃裂囊肿(瘘)最常见,术前B超检查对鳃裂囊肿(瘘)有较高的确诊率,首次手术完整切除囊肿与瘘管是治疗成功的关键。PURPOSE： To investigate the clinical manifestation of branchial cleft cyst （fistula） and provide some clinical experience on its diagnosis and treatment. METHODS： From June 1993 to December 2006, two hundred and eighty-four patients with branchial cleft cyst or fistula underwent surgical treatment were retrospectively reviewed, the preoperative examinations, preoperative diagnosis and postoperative pathological diagnosis were recorded, and the data was analyzed with SAS6.12 software package. RESULTS： Among the 284 patients with branchial cleft cyst or fistula confirmed by postoperative pathological diagnosis, there were 132 patients （46.5%） with first branchial cleft cyst or fistula, one hundred and forty-five patients （51.1%） with second branchial cleft cyst or fistula, and 7 patients （2.4%） with third branchial cleft cyst or fistula. First branchial cleft cyst or fistula often occurred in patients older than 40 years, second and third brancbial cleft cyst or fistula often occurred in patients younger than 40 years. The pathological diagnosis confirmed 188 primary lesions, thirty-three recurrent lesions, forty-four lesions with internal fistula, fourteen lesions with secondary infection and external fistula, and three lesions with both internal and external fistulae. One patient was found with tuberculosis simultaneously, two patients with multiple cysts, one patient with venous malformation. Six lesions were found malignant, five from first branchial cleft and one from second branchial cleft. The highest accuracy of preoperative diagnosis was 66.20% using ultrasonography. During the follow-up period, 5.98% of patients had recurrence. CONCLUSIONS： First and second branchial cleft cysts （fistula） are the most common lesions. Preoperative uftrasonography is the first choice for diagnosis of branchial cleft cyst （fistula）. Complete resection including the cyst and fistula is the key to successful surgical treatment. Supported by Shanghai Leading Academic Discipline Project （Grant N

关 键 词：鳃裂囊肿 鳃裂瘘 复发 回顾性研究 

分 类 号：R762[医药卫生—耳鼻咽喉科]