耳后皮瓣治疗儿童难治性耳前瘘管的疗效观察  

The Effect of Retroauricular in Skin Flap on Refractory Preauricular Fistula in Children

作　　者：文武林 李永春 马瑞霞 朱思敏 王国珍 闫小会[4] 周宇[4] WEN Wulin;LI Yongchun;MA Ruixia;ZHU Simin;WANG Guozhen;YAN Xiaohui;ZHOU Yu(The First People's Hospital of Yinchuan(The Second Affiliated Hospital of Ningxia Medical University),Yinchuan 750001,China;Yinchuan Traditional Chinese Medicine Hospital,Yinchuan 750001,China;Zhongwei People's Hospital,Zhongwei 751700,China;General Hospital of Ningxia Medical University,Yinchuan 750004,China)

机构地区：[1]银川市第一人民医院(宁夏医科大学第二临床学院),银川750001 [2]银川市中医医院,银川750001 [3]宁夏中卫市人民医院,中卫751700 [4]宁夏医科大学总医院,银川750004

出　　处：《宁夏医科大学学报》2022年第10期1059-1062,共4页Journal of Ningxia Medical University

基　　金：宁夏回族自治区重点研发计划项目(2022BEG03103)。

摘　　要：目的探讨儿童难治性耳前瘘管颞浅筋膜入路根治性切除并同侧耳后沟带蒂皮瓣修复手术治疗的临床疗效。方法将90例难治性耳前瘘管患儿分为对照组和实验组,各45例。对照组患儿给予耳前感染区外科换药后,再常规术式切除耳前瘘管,术区予以减张拉拢缝合。实验组患儿直接行颞浅筋膜入路根治性切除耳前瘘管及其周围的感染组织,同时切取适当大小的同侧耳后沟带蒂皮瓣修复耳前较大的皮肤缺损范围,比较两组患儿临床疗效。结果实验组患儿Ⅰ期愈合率(95.56%)高于对照组(77.78%)(P<0.05);实验组患儿的术前治疗时间、术后治疗时间及总治疗时间均短于对照组(P均<0.05);两组患儿的术区美观满意率差异无统计学意义(χ^(2)=2.133,P>0.05)。结论与常规方法相比,采用颞浅筋膜入路根治性切除联合同侧耳后沟带蒂皮瓣修复术区治疗儿童难治性耳前瘘管,治疗时间更短,疗效更佳。Objective To investigate the clinical effect of radical resection of refractory preauricular fistula through superficial temporal fascia approach and repair of ipsilateral posterior auricular sulcus with pedicled flap.Methods Ninety cases of refractory preauricular fistula were divided into control group and experimental group,with 45 cases in each.The control group was treated with surgical dressing change in the area of preauricular infection,and then the preauricular fistula was removed by conventional operation and the intraoperative area was tensioned and sutured.In the experimental group,radical resection of preauricular fistula and its surrounding infected tissue was performed by superficial temporal fascia approach.Meanwhile,appropriate ipsilateral posterior auricular sulcus pedicled flap was cut to repair the large preauricular skin defect.The clinical efficacy of the two groups was compared.Results The healing rate in the experimental group(95.56%)was higher than that in the control group(77.78%)(P<0.05).The preoperative treatment time,postoperative treatment time and total treatment time of the experimental group were shorter than those of the control group(P all<0.05).There was no significant difference in aesthetic satisfaction rate between the two groups(χ^(2)=2.133,P>0.05).Conclusion Compared with conventional methods,the treatment of refractory preauricular fistula in children by radical resection of superficial temporal fascia combined with pedicled flap of ipsilateral posterior auricular sulcus was shorter and more effective.

关 键 词：感染期耳前瘘管 耳后沟带蒂皮瓣 先天性耳前瘘管 难治性耳前瘘管 

分 类 号：R764.45[医药卫生—耳鼻咽喉科]