儿童皮毛窦的诊断及治疗效果分析

Diagnosis and surgical treatment of dermal sinus tracts in children

目的探讨儿童皮毛窦的诊断方法和手术治疗效果。方法回顾性分析山东大学齐鲁儿童医院2015年1月至2018年6月收治的15例儿童皮毛窦患儿临床资料,所有患儿术前接受MRI检查,且行皮毛窦切除术。结果术前影像学检查发现15例均有皮肤窦道。5例合并皮样囊肿;2例合并脂肪瘤;1例合并脊髓纵裂;1例合并中央管扩大。脊柱三维CT重建检查发现10例合并脊柱裂。术后病理结果均证实为皮毛窦。镜下可见毛发毛干,窦道及其周围组织,炎性肉芽增生组织。所有患儿均获得随访,随访时间6~12个月,术前症状消失或明显改善,窦道未见复发。结论儿童皮毛窦早期诊断及手术治疗有助于改善患儿预后及减少严重并发症的发生。

Objective To explore the diagnostic methods and surgical efficacies of dermal sinus tracts.Methods The clinical data of 15 hospitalized children with dermal sinus tracts from January 2015 to June 2018 were retrospectively analyzed.All children received preoperative magnetic resonance imaging(MRI)examination and underwent dermal sinus tract resection.Results All cases were confirmed by imaging examinations.The concurrent conditions included dermoid cyst(n=5),lipoma(n=2),diastematomyelia(n=1)and ectattic central canal(n=1).Three-dimensional computed tomography(CT)spinal reconstruction revealed complicated diastematomyelia(n=10).Postoperative pathological examination confirmed the diagnosis of dermal sinus tracts.And microscopic examination revealed hair stem,sinus tract and adjoining tissues with inflammatory granulation.During a follow-up period of 6-12 months,the symptoms disappeared or improved significantly after operation.No recurrence of sinus tract was found.Conclusion Early diagnosis and surgical treatment of dermal sinus in children can improve the prognosis and reduce the occurrence of serious complications.