手术切除配合整形治疗复杂性耳前瘘管的临床疗效及预后

The Clinical Effect and Prognosis of Resection with Plastic Surgery in the Treatment of Complicated Preauricular Fistula

目的探讨整形配合手术切除治疗复杂性耳前瘘管的临床疗效及预后情况。方法选取2013年3月至2014年3月秦皇岛市第一医院接诊的复杂性耳前瘘管患者120例,按照随机数字表法分为观察组和对照组,各60例。观察组采用面部美容切口联合对局部的皮瓣进行转移治疗,对照组采用单纯的瘘管切除术。观察两组患者治疗后脓肿愈合时间、换药疼痛度、住院时间、术中出血量、不良反应发生率、临床疗效、满意度以及对患者进行1年以上的随访,观察其复发的情况。结果观察组脓肿愈合时间、换药疼痛度、住院时间、术中出血量显著低于对照组[(4.7±1.0)d比(10.3±2.2)d,(4.2±0.6)比(7.2±1.3),(6.2±1.2)d比(12.1±3.4)d,(152±29)m L比(243±47)m L];观察组治疗后总有效率、满意度均高于对照组[83.3%(53/60)比70.0%(42/60),93.3%(56/60)比66.7%(40/60)],复发率显著低于对照组[5.0%(3/60)比20.0%(12/60)],差异有统计学意义(P<0.05),观察组不良反应发生率显著低于对照组[25.0%(15/60)比46.7%(28/60)],差异有统计学意义(P<0.05)。结论整形配合手术切除治疗复杂性耳前瘘管疗效显著,术后愈合快、复发率低,而且能够保持患者面部的美观,值得在临床上应用推广。

Objective To investigate clinical effect and prognosis of the resection with plastic surgery in the treatment of complicated preauricular fistula. Methods Total of 120 patients with complicated preaurieular fistula in Qinhuangdao First Hospital from Mar. 2013 to Mar. 2014 were included in the study,and divided into an observation group （60 cases） and a control group（60 cases） according to the random number table method. The observation group was treated with facial incision combined with local flap transfer,and the control group was treated with simple fistula resection. The abscess healing time, dressing pain, length of hospital stay, adverse reaction incidence, clinical efficacy, satisfaction of the two groups after treatment were observed, and the patients were followed up for more than 1 year to observe the recurrence. Results The healing time, dressing change pain,length of hospital stay, and the intraoperative bleeding amount of the observation group were lower than the control group （4. 7 ± 1.0 ） d vs （ 10.3 ± 2.2 ） d, （4.2 ± 0.6 ） vs （7.2 ± 1.3 ）, （6.2 ± 1.2 ） d vs （ 12. 1 ± 3.4 ） d, （ 152 ± 29 ） mL vs （243 ± 47 ） mL; the total effective rate and satisfaction degree of the observation group were higher than the control group[ 83.3% （53/60） vs 70.0% （42/60） ,93.3% （56/60） vs 66. 7% （40/60） ], the recurrence rate of the observation group was lower than the control group [ 5.0% （3/60） vs 20. 0% （ 12/60 ± ], with statistically significant difference （ P 〈 0. 05 ）. The incidence of adverse reactions of observation group was±ower than the control group[ 25.0% （15/60） vs 46.7% （28/ 60） ], with statistically significant difference （P 〈 0.05 ）. Conclusion Plastic surgery combined with resection in the treatment of complicated preanricular fistula has significant curative effect, fast postoperative healing,low recurrence rate, and can maintain the facial beauty of the patients, thus is worthy of application in clinical.