新生儿梨状窝瘘的诊治特点

Diagnosis and treatment of pyriform sinus fistula in neonates

目的 阐述新生儿梨状窝瘘这一少见疾病的诊治特点.方法 收集我院2001年7月至2010年1月收治的9例新生儿梨状窝瘘病例,分析其发病年龄、临床表现、辅助检查及临床治疗经过,总结其诊治特点和预后.结果 9例梨状窝瘘均为左侧.均以颈部囊性肿块就诊.8例为新生儿时期出现症状,1例为产前发现.5例颈部增强CT提示肿块中含有气体.新生儿时期手术治疗7例.随访时间6个月至9年,患儿临床均无反复感染或复发迹象.结论 新生儿的梨状窝瘘临床表现不同于儿童,常因颈部无痛性、囊性肿块就诊,缺少反复脓肿切开引流史.超声或CT检查中常可发现囊肿中含有气体影.新生儿早期手术瘘管结扎率高,部分需要胃镜辅助.治疗安全性可靠,术后复发率低且预后良好.

Objective To summarize the features of the diagnosis and treatment of pyriform sinus fistula in neonates. Methods Between July 2001 and January 2010,9 neonates were diagnosed with pyriform sinus fistula and treated at this department. The age at diagnosis, clinical features, results of ultrasound or CT examination, treatment and prognosis in all patients were retrospectively reviewed to summarize the characteristics of the diagnosis and prognosis of neonatal pyriform sinus fistula. Results The pyriform sinus fistulas of the 9 patients were on the left lateral neck. All patients visited doctors for cystic neck masses. Eight patients symptoms started in neonatal period, and 1 patient was diagnosed before birth. The CT scanning of the 5 patients found gas in the masses. Seven patients underwent surgery in neonatal period,and were followed up for 6 months to 9 years after surgery. No recurrence of pyriform sinus fistula was noted. Conclusions The neonatal pyriform sinus fistula usually starts with painless and cy