双极电凝镊联合显微镜在儿童先天性耳前瘘管感染期手术治疗中的经验总结  

Experience of bipolar electrocoagulation forceps combined with microscope in surgical treatment of congenital preauricular fistula infection in children

作　　者：周明朗[1] 柴伟[1] 黄辉[1] 何苗[1] 冀庆军 付凡巍 王丽 冯春博 Zhou Minglang;Chai Wei;Huang Hui;He Miao;Ji Qingjun;Fu Fanwei;Wang Li;Feng Chunbo(Department of Otorhinolaryngology Head and Neck Surgery,Bozhou People's Hospital,Bozhou 236800,China)

机构地区：[1]亳州市人民医院耳鼻咽喉头颈外科,亳州236800

出　　处：《国际耳鼻咽喉头颈外科杂志》2023年第3期135-137,共3页International Journal of Otolaryngology-Head and Neck Surgery

摘　　要：目的探讨双极电凝联合显微镜在儿童先天性耳前瘘管感染期手术中的应用,分析总结其安全性和可行性。方法总结分析亳州市人医院2018年1月至2020年12月收住院并行手术治疗的感染期先天性耳前瘘管患儿50例,年龄1~11岁,平均年龄6.5岁,均为单侧感染期手术,术前明确耳前瘘管合并感染,经抗炎治疗并根据情况切开引流换药3~5次后及时行手术治疗,手术采用全身麻醉,术中使用双极电凝配合显微镜完全切除瘘管组织,同时清理感染灶,术前切开引流口根据情况在术中尽可能采取缝合措施。结果术后46例愈合良好,按时拆线,4例术后切口延迟愈合,经积极换药后痊愈。常规随访半年,无复发病例。结论先天性耳前瘘管患儿感染期手术可以有效减少感染期反复换药对患儿带来的痛苦,同时双极电凝联合显微镜感染期手术可以达到更好地控制出血、彻底分离并切除瘘管组织,术后随访无复发病例,值得临床推广。Objective To investigate the application of bipolar coagulation combined with microscopy in treatment of infected congenital preauricular fistula in children and to analyze and summarize its safety and feasibility.Methods From January 2018 to December 2020,50 children with infected congenital preauricular fistula,aged 1-11 years,with an average age of 6.5 years,were summarized.They were all unilateral infection operations.Preoperative diagnosis of preauricular fistula complicated with infection.After anti-inflammatory treatment,surgical treatment was performed in time after 3-5 times of incision,drainage and dressing change according to the situation.General anesthesia was used for the operation.The fistula tissue was completely removed by bipolar electrocoagulation combined with microscope during operation,and the infected focus was cleaned at the same time.Open the drainage orifice before operation and take suture measures as much as possible according to the situation during operation.Results 46 cases healed well and stitches were removed on time,while 4 cases delayed healing and recovered after active dressing change.Routine follow-up for half a year showed no recurrence.Conclusions Surgery for children with congenital preauricular fistula in infection period can effectively reduce the pain caused by repeated dressing change in infection period.Bipolar electrocoagulation combined with microscopic surgery in infection period can better control bleeding,completely separate and remove fistula tissue,and there is no recurrence during postoperative follow-up,which is worthy of clinical promotion.

关 键 词：儿童 外科手术 显微镜检查 双极电凝镊 先天性耳前瘘管 

分 类 号：R764.9[医药卫生—耳鼻咽喉科]