内镜下改良电刀吸引器对婴幼儿混合性先天性后鼻孔闭锁的疗效观察  

Observation on the efficacy of endoscopic modified electric knife aspirator in the treatment of mixed congenital choanal atresia in infants

作　　者：吴鸿泉[1] 刘展[1] 吴正规[1] Wu Hongquan;Liu Zhan;Wu Zhenggui(Department of Otorhinolaryngology-Head and Neck Surgery,The First Affiliated Hospital of Guangxi Medical University,Nanning 530021,China)

机构地区：[1]广西医科大学第一附属医院耳鼻咽喉头颈外科,南宁530021

出　　处：《广西医科大学学报》2022年第5期838-842,共5页Journal of Guangxi Medical University

摘　　要：目的:探讨内镜下利用改良电刀吸引器手术治疗婴幼儿混合性先天性后鼻孔闭锁的临床疗效。方法:选择2015年2月至2020年11月广西医科大学第一附属医院耳鼻咽喉头颈外科收治的9例婴幼儿混合性先天性后鼻孔闭锁的临床资料,所有患儿经过鼻纤维内镜和鼻咽部CT检查确诊后均在内镜下利用改良电刀吸引器进行手术,术中常规放置扩张管,观察并记录患儿手术时间、出血量、术中并发症(术中鼻腔各结构、圆枕、咽鼓管口、颅底等结构有无损伤)、置管时间等情况,术后随访6个月。结果:9例患儿中8例1次治愈,1例双侧CCA置管1个月的患儿术后2年单侧再次狭窄,经再次手术后治愈;术后随访所有患儿鼻通气恢复正常,无手术并发症发生,鼻内镜下检查成形的后鼻孔未发生再次狭窄或闭锁。结论:内镜下利用改良电刀吸引器对婴幼儿混合性先天性后鼻孔闭锁进行手术治疗安全有效,具有创伤小、出血少、手术时间短、保护正常组织结构、手术并发症少的优势,值得推广应用。Objective:To explore the clinical effect of endoscopic modified electric knife attractor in the treatment of congenital choanal atresia(CCA).Methods:The clinical data of 9 infants with mixed CCA treated in Department of Otolaryngology-Head and Neck Surgery,The First Affiliated Hospital of Guangxi Medical University from February 2015 to November 2020 were selected as subjects.After being diagnosed by nasopharyngeal fibroscope and nasopharyngeal CT scan,all children were operated with modified electric knife aspirator under endoscope,and dilatation tubes were routinely placed during the operation.The operation time,blood loss,intraoperative complications(injury of nasal cavity,torus,eustachian tube,skull base,etc.)and catheterization time were observed and recorded.The patients were followed up for 6 months.Results:Among the 9 cases,8 cases were cured successfully,and 1 case with bilateral CCA catheterization for 1 month had unilateral restenosis 2 years after operation,which was cured after reoperation.During the follow-up,all patients’nasal ventilation returned to normal,no operative complications occurred,and no restenosis or atresia occurred in the posterior nostril formed by nasal endoscopy.Conclusion:Endoscopic modified electric knife attractor in the treatment of infant mixed CCA is safe and effective,with the advantages of less trauma,less bleeding,short operation time,protection of normal tissue structure and less operative complications.It is worth popularizing and applying.

关 键 词：先天性后鼻孔闭锁 混合性 内镜手术 婴幼儿 扩张管 

分 类 号：R765.9[医药卫生—耳鼻咽喉科]