儿童先天性梨状窝瘘感染期的手术治疗及术后疗效分析  

Clinical analysis of surgical treatment and postoperative efficacy in piriform sinus fistula with acute inflammatory period of children

作　　者：郭宇峰 高兴强 许政敏[2] 邓海燕[1] 吴晓慧 GUO Yufeng;GAO Xingqiang;XU Zhengmin;DENG Haiyan;WU Xiaohui(Department of Otolaryngology Head and Neck Surgery,Xiamen Children's Hospital,Xiamen,361001,China;Department of Otolaryngology Head and Neck Surgery,Children's Hospital of Fudan University)

机构地区：[1]复旦大学附属儿科医院厦门医院厦门市儿童医院耳鼻咽喉头颈外科,福建厦门361001 [2]国家儿童医学中心复旦大学附属儿科医院耳鼻咽喉头颈外科

出　　处：《临床耳鼻咽喉头颈外科杂志》2025年第2期158-162,共5页Journal of Clinical Otorhinolaryngology Head And Neck Surgery

摘　　要：目的:探讨在儿童先天性梨状窝瘘感染期,采用支撑喉镜下内镜辅助低温等离子梨状窝瘘口射频消融术联合颈部脓肿切开引流术的临床疗效。方法:对厦门市儿童医院耳鼻咽喉头颈外科2018年1月-2023年12月接受上述联合手术治疗的30例先天性梨状窝瘘感染期患儿的临床资料进行了回顾性分析。术后,患儿均进行了密切的阶段性随访,包括颈部彩超和电子喉镜检查,以评估治疗效果。结果:30例患儿均成功完成了手术,术后未出现咽瘘、吞咽困难或内瘘口周围及瘘管深部感染,颈侧脓肿的切排创面愈合良好。随访6个月~2年,无一例复发。结论:低温等离子射频消融术处理梨状窝内瘘口联合颈侧脓肿切开引流术在治疗儿童先天性梨状窝瘘感染中显示出创伤小、操作简单、安全有效且复发率低的优势。这一联合手术方法为儿童先天性梨状窝瘘的治疗提供了新的治疗途径。Objective To discuss the clinical efficacy of low-temperature radiofrequency ablation assisted by endoscopy combined with resection and drainage of cervical abscess for the treatment of congenital pyriform sinus fistula(CPSF)in the acute inflammatory period of children.Methods Clinical data of 30 patients with CPSF in the acute inflammatory period who received low-temperature radiofrequency ablation assisted by endoscopy under laryngoscope,combined with resection and drainage of cervical abscess,from January 2018 to December 2023 were reviewed.After the operation,patients were followed up closely at different stages.All patients underwent color Doppler ultrasound and electronic laryngoscopy,and the results were analyzed.Results All 30 children successfully completed the surgery without pharyngeal fistula,dysphagia,perifistula,or distal fistula infection,and the incision in the neck healed well.The follow-up survey ranged from 6 months to 2 years,and no recurrences were observed.Conclusion Low-temperature radiofrequency ablation assisted by endoscopy combined with resection and drainage of cervical abscess is a promising method for treating CPSF in the acute inflammatory period.It is less traumatic,simple,safe,has a significant curative effect,and a low recurrence rate.This approach can be used as a supplementary operation for CPSF in children and provides a new way for clinical treatment.

关 键 词：低温等离子射频消融术 儿童 先天性梨状窝瘘 感染期 

分 类 号：R766.9[医药卫生—耳鼻咽喉科]