骶尾部藏毛窦9例临床分析

Clinical analysis of sacroiliac pilonidal sinus in nine cases

目的提高对骶尾部藏毛窦临床诊断和治疗的认识。方法 9例骶尾部藏毛窦患者,经泛影葡胺窦道造影、直肠指诊、骶尾骨X线片确诊。2例行藏毛窦切除、切口敞开术,2例行藏毛窦切除、部分缝合术,5例范围较小者采用单纯藏毛窦切除一期缝合术。结果 2例行藏毛窦切除、切口敞开术者分别于术后30、46 d愈合。2例行藏毛窦切除、部分缝合术者分别于术后35、40 d愈合。5例单纯藏毛窦切除一期缝合术者中,1例术后5 d感染,拆线后换药35 d痊愈;1例切口因切缘两端不能闭合,10 d拆线,换药后40 d愈合;另3例均于15 d左右一期拆线痊愈。随访0.5～6.0 a未见复发。结论骶尾部藏毛窦具有高致病因素,诊断容易明确,手术方式应根据患者窦口、窦道的数量和范围、炎症情况、技术认识等情况来选择。

Objective To improve the understanding of clinical diagnosis and treatment for sacroiliac pilonidal sinus.Methods Nine patients with sacroiliac pilonidal sinus were diagnosed by cardiografin contrast fistulography,rectal touch,sacrococcyx X-line.They were all taken operation to remove pilonidal sinus,two of them with open wide cut,two with part sutura,and five with primary suture.Results The two patients with open wide cut healed after thirty days and forty-six days respectively.The two patients with part sutura healed after thirty-five days and forty days respectively.Among the five patients with primary suture,one infected after five days and healed in the 35th day after sutures out and changing dressings;One was taken sutures out after 10 days because that amphi-cutting edge could not close up,and healed in the 40th day after changing dressings;The other three patients healed after about fifteen days post-primary suture.All patients were followed up for 0.5-6.0 years,and there was no recurrent cases.Conclusion The sacroiliac pilonidal sinus has high etiological factors.The diagnosis of the disease is easy and clear.Adopting which method depends on the number and range of the ostium and sinus,the inflammation and the recognition of technology and so on.