新生儿及婴儿会厌囊肿手术方式的探讨

Surgical Management of Congenital Epiglottic Cyst in Infants

目的探讨婴幼儿会厌囊肿治疗方法及疗效。方法 1995年7月～2011年7月对69例新生儿及婴儿会厌囊肿患者行手术治疗,其中钳除术17例,剪切术11例,圈套器摘除术35例,低温等离子射频消融术6例,分析其疗效、手术时间、术中出血量和术后恢复时间。结果 17例钳除术患儿术后有2例复发,治愈率88.24%,手术时间平均约25.8分钟,术中出血平均4.2毫升,术后恢复时间平均6.73天;11例剪切术患儿2例复发,治愈率81.82%,手术时间平均约23.7分钟,术中出血平均3.6毫升,术后恢复时间平均5.21天;35例圈套器摘除术患儿术后无一例复发,治愈率100%,手术时间平均约11.6分钟,术中出血平均1.6毫升,术后恢复时间平均3.76天;6例低温等离子射频消融术患儿术后无一例复发,治愈率100%,手术时间平均约13.5分钟,术中无出血,术后恢复时间平均7.56天。结论圈套器摘除术和低温等离子射频消融术是治疗新生儿及婴儿会厌囊肿安全、有效的手术方式。

Objective To investigate the best surgical management for congenital epiglottic cyst in infants. Methods Four surgical appoaches were employed in 69 cases of epiglottic cyst, which were puncture, clamp gnaw, clamp shear, nasal polyp snare removing, and plasma coblation. Results Four aspects of therapeutic effect, total operation time, intraoperative bleeding and postoperative recovery time were compared. In clamp snap group, 2 of 17 cases were recurrent, mean operative time was 25.8 minutes,intraoperative bleeding was 4.2 ml, recovering time was 6.73 days. In clamp shear group, 2 of 11 cases were recurrent, mean operative time was 23.7 minutes, intraoperative bleeding was 3.6 ml, recovering time was 5.21 days. In nasal polyp snare group, none of 35 cases was recurrent, average operative time was 11.6 minutes, intraoperative bleeding was 1.6 ml, recovering time was 3.76 days. In plasma coblation group, none of 6 cases was recurrent, mean operative time was 13.5 minutes, intraopera- tive bleeding was 0 ml, and recovering time was 7.56 days. Conclusion Nasal polyp snare and plasma coblation were effective, easy and safe surgical appoaches.