颈部囊肿与瘘管的诊断和治疗  

Diagnosis and treatment for neck cyst and fistula

作　　者：蔡建峰[1] 曹锦康[1] 

机构地区：[1]上海中医药大学附属岳阳医院耳鼻喉科,上海200439

出　　处：《山东医大基础医学院学报》2001年第6期356-357,共2页

摘　　要：目的：总结颈部囊肿与瘘管的诊治经验。方法：９３例行手术治疗，其中鳃裂囊肿１５例，鳃裂瘘管１０例，皮样囊肿１例，囊状淋巴管瘤４例，甲状舌骨囊肿３７例，甲状舌管瘘管２５例，癌性淋巴液囊肿１例，随访１～１０年。结果：９３例中，囊性淋巴管瘤１例复发后失访，另１例行２次手术，癌性淋巴液囊肿１例半年后死于肺转移，鳃裂瘘管２例３次手术，甲状舌管瘘管１例复发，鳃裂瘘管术后１例迟发性面瘫，一次手术治愈，无术后并发症。结论：颈部囊肿与瘘管的诊断除依据术前检查外，主要是依据术中的发现和术后病理检查。Ｂ超、ＣＴ等是有效的辅助检查手段。治疗上应彻底切除囊壁与瘘管，避免复发。术中应避免损伤颈部的大血管和神经。甲状舌管瘘管须切除舌骨中段２ｃｍ，这是防止术后复发的关键。Objective:To study the experience in diagnosis and treatment of neck cyst and fistul a.Method:All of the 93 patients were surgeried.Among them,15 were brach ial cyst,ten were brachial fistula,one was dermoid cyst,4 were lymphangioma cysticum,37 were thyroglossal cyst,25 were thyroglossal fistula,and one was cancerous lymphadenocele.All of the patients were followed up for 1～10 years.Result:Among these 93 patients,one lymphangioma cysticum patient recurred and missed communication,while an other patient was surgeried two times;one cancerous lymphadenocele died of lung matastasis half a year later;two brachial fistula patients were surgeried three times;one thyroglossal fistula patient recurred;one brachial cyst patient suffered peripheral facial paralysis after surgery,and others were cured without complication.Conclusion:Discoveries in surgery and the pathologic examination play the key role and B ultrasonic and CT are al so effective methods in diagnosis of neck cyst and fistula.It is important to cut the cyst and fistula completely to avoid recurring.To be familiar with anatomy is very important to avoid injury the huge vascular and nerve.In the treatment of thyroglossal fistula,cutting off 2cm of the middle part of the hyoid is the key for preventing relapse.

关 键 词：颈部囊肿 瘘 治疗 诊断 

分 类 号：R653[医药卫生—外科学]