借鉴分区性颈清扫操作技术切除颈部非肿瘤病变13例

Selective neck dissection for reference in treating noncancerous diseases in the neck

目的探讨分区性颈清扫技术在颈部非肿瘤病例中的应用。方法借鉴分区性颈清扫技术对颈部非肿瘤病变进行切除,其中有脓肿型或溃疡型颈淋巴结核5例、复发鳃裂瘘管7例、颈部肿物经切取活检后形成囊肿1例。所有病例均采取整块切除病变组织。结果颈清扫技术有利于彻底清除与周围组织粘连紧密、分界欠清、范围较广、并且常规治疗效果欠佳的病变。本组病例未出现副神经和喉返神经损伤、切口愈合不良等并发症。术后随访5个月至2年均未见复发。结论参照分区性颈清术的手术技术处理复发型第2、3鳃裂瘘管和有脓肿(≥3cm)或瘘管形成的颈淋巴结核,可取得较好的临床疗效。

Objective To investigate the effect of selective neck dissection （SND） in treating noncancerous neck diseases. Methods Thirteen patients （5 abscessor ulcer-lymphoid tuberculosis, 7 recurrent branchial fistula, 1 trachelophyma after biopsy） were treated by RND. All pathologically abnormal tissues were completely dissected. Results RND was good in removing the pathologically changes which were closely sticking to peripheral tissues with an indefinite boundary, widely distributed and had an undesired effect after conventional treatments. No accessory nerve or laryngeal nerve injury adverse wound healing occurred in this present study. Conclusion RND is effective in the treatment of recurrent second and third bronchial fistula, and abscessformed （ 〉 3 cm） or fistulized lymphoid tuberculosis.