低温等离子射频消融治疗37例梨状窝瘘的临床分析  

Clinical analysis of radiofrequency ablation in the treatment of piriform fossa fistula in 37 cases

作　　者：李万鹏[1,2] 浦诗磊 刘晓君 徐宏鸣 赵利敏[1] 李晓艳[1] LI Wanpeng;PU Shilei;LIU Xiaojun;XU Hongming;ZHAO Limin;LI Xiaoyan(Department of Otolaryngology Head and Neck Surgery,Children Hospital of Shanghai,Shanghai Jiao Tong University,Shanghai 200062,China)

机构地区：[1]上海交通大学附属儿童医院耳鼻咽喉头颈外科,上海200062 [2]复旦大学附属眼耳鼻喉科医院耳鼻喉科,上海200031

出　　处：《中国眼耳鼻喉科杂志》2019年第6期395-399,共5页Chinese Journal of Ophthalmology and Otorhinolaryngology

摘　　要：目的探讨低温等离子射频消融治疗梨状窝瘘适应证的选择及疗效。方法2016年1月~2017年12月就诊于上海交通大学附属儿童医院耳鼻咽喉头颈外科的37例梨状窝瘘患儿,其中26例患儿处于炎症静止期,采用低温等离子射频消融方法治疗;11例患者处于急性感染期,采用低温等离子射频消融联合颈部脓肿切开引流方法治疗。所有患儿术后给予鼻饲饮食2周。观察所有患儿术后并发症(声音嘶哑、颈部肿胀)及复发情况。结果3例患儿术后出现暂时性声音嘶哑,术后1个月均恢复正常。4例患儿在术后3 d出现患侧颈部肿胀,伴有发热,给予颈部脓肿切开排脓,颈部伤口换药1周左右痊愈。术后随访6个月~2年(中位随访时间为13个月),所有患儿均未见复发。结论低温等离子射频消融治疗梨状窝瘘具有微创、易操作、并发症较少、复发率低等优点,在治疗炎症静止期和感染期的梨状窝瘘都具有良好的疗效,为治疗急性炎症期梨状窝瘘提供了新的思路。Objective To explore the selection of indications and the curative effect of radiofrequency ablation(RA)in the treatment of piriform fossa fistula(PSF).Methods A prospective study was conducted in 37 cases of PSF in Shanghai Children's Hospital,Department of Otolaryngology Head and Neck Surgery from Jan.2016 to Dec.2017.Twenty-six cases in the quiescent stage of inflammation were treated with RA for PSF;11 cases in the inflammatory infection stage were treated with RA combined with abscess incision and drainage.The nasal feeding was given for two weeks after the operation in all cases.The complications(such as hoarseness,neck swelling)and recurrence of all cases were observed.Results Three cases had a postoperative temporary hoarseness and the hoarseness returned to normal after one month.In four cases,there were swelling or abscess on the side of the affected side 3 days after the operation,accompanied by fever.After incision and drainage of the neck abscess,the neck wound was healed in one week.All patients were followed up for 6 months to 2 years(median follow-up period was 13 months)and no recurrence was found.Conclusions RA for PSF has the advantages of minimally invasion,easy operation,less complications and low recurrence rate.It has good curative effect in the treatment of quiescent stage and inflammatory infection of PSF,which provides a new way of thinking for the treatment of PSF in acute inflammatory period.

关 键 词：梨状窝瘘 射频消融 内镜 儿童 

分 类 号：R47[医药卫生—护理学]