鳃裂畸形159例临床分析

Clinical analysis of branchial anomalies: report of 159 cases

目的总结159例先天性鳃裂畸形病例资料,对其诊断、治疗及预后进行探讨。方法回顾分析2005年1月至2016年12月经手术治疗的159名鳃裂畸形患者的临床资料。纳入研究的项目包括患者年龄、性别、部位、畸形类型、治疗历史、手术治疗、并发症和复发情况等。结果其中男性患者73人,女性患者86人,儿童患者占15.7%。在所有患者中,诊断为第一鳃裂囊肿的为34人(21.4%),诊断为第二鳃裂囊肿的为112人(70.4%),诊断为第三、第四鳃裂囊肿的为13人(8.2%)。所有患者均于我院进行了手术。儿童患者、曾行切开引流或复发的成人患者进行了显微镜下的手术操作,精确切除的复发率明显降低。面神经颞支损伤和伤口感染是外科治疗的主要并发症。本组患者的总体复发率为3.8%。结论相对于以往的报道,本研究鳃裂畸形的术后复发率更低。利用显微镜的显微手术和精细的操作器械在鳃裂囊肿手术中发挥重要作用。

Objective To analyze the management and treatment outcome of patients with branchial anomalies(BAs).Methods A total of 159 consecutive cases with branchial cleft,who received treatment from February 2005 to December 2016,were retrospectively analyzed.The clinical features that were studied included age,sex,location,type of anomaly,history of treatment,surgical treatment,complications,and recurrence.Results There were 73 males and 86 females,and the pediatric patients accounted for 15.7%.A total of 34(21.4%)patients presented with first branchial cleft,112(70.4%)with second branchial cleft,and 13(8.2%)with third and fourth branchial cleft.All patients underwent surgical treatment.Microdissection was performed in pediatric and adult patients that recurred during surgical procedure.Temporary facial nerve injury and wound infection were major complications of surgical treatment.The recurrence rate of the lesions was 3.8%.Conclusion The incidence of recurrence was lower in this group of patients compared with previous report.Microdissection by using microscope and delicate microsurgical instruments may play an important role in surgery.