感染期耳前瘘管术中炎性皮肤保留的探索

Exploration of inflammatory skin preservation during the operation of preauricular fistula in infection stage

目的探讨感染期耳前瘘管术中炎性皮肤保留的应用效果。方法选取2019年1月~2020年1月在莆田学院附属医院耳鼻咽喉科和莆田涵江医院耳鼻咽喉科诊治的50例先天性耳前瘘管脓肿期患者作为研究对象,采用分层随机抽样法分为试验组与对照组,各25例。试验组采用小梭形切口并向下延长1~2 cm,保留炎性皮肤。对照组采用大梭形或双梭形切口。术后随访观察1个月~1年,比较两组先天性耳前瘘管脓肿期的治疗效果、并发症发生率、局部瘢痕长度及复发率。结果试验组先天性耳前瘘管脓肿期的总有效率为88.00%,与对照组的96.00%比较,差异无统计学意义(P>0.05)。两组先天性耳前瘘管脓肿期的并发症总发生率比较,差异无统计学意义(P>0.05)。试验组的局部瘢痕长度为(8.16±1.28)mm,短于对照组[(18.08±1.73)mm],差异有统计学意义(P<0.05)。试验组的复发率为8.00%,与对照组的4.00%比较,差异无统计学意义(P>0.05)。结论对于先天性耳前瘘管脓肿期患者,适当控制炎症后采用小梭形切口进行手术,同时辅以术中炎性皮肤保留等手术技巧可以取得同样的治疗效果,能够改善瘢痕,且不增加复发率。

Objective To explore the application effect of inflammatory skin preservation in the operation of preauricular fistula in the period of infection.Methods From January 2019 to January 2020,50 patients with congenital preauricular fistula and abscess in the Department of Otolaryngology of Affiliated Hospital of Putian University and Putian Hanjiang Hospital were selected as the study objects.The patients were divided into the experimental group and the control group by stratified random sampling,25 cases in each group.In the experimental group,the small fusiform incision was used and extended down 1 to 2 cm,and the inflammatory skin was preserved.In the control group,large fusiform or double fusiform incision was used.The patients were followed up for 1 month to 1 year.The therapeutic effect,the incidence rate of complication,local scar length and recurrence rate of the two groups were compared.Results The total effective rate of the experimental group was 88.00%,compared with 96.00%of the control group,there was no significant difference(P>0.05).There was no significant difference in the total incidence of complications between the two groups(P>0.05).The local scar length in the experimental group was(8.16±1.28)mm,which was significantly shorter than(18.08±1.73)mm in the control group,the difference was statistically significant(P<0.05).The recurrence rate of the experimental group was 8.00%,compared with 4.00%of the control group,there was no significant difference(P>0.05).Conclusion For the patients with congenital preauricular fistula and abscess stage,the same therapeutic effect can be achieved by using small fusiform incision after proper control of inflammation,supplemented by surgical techniques such as inflammatory skin preservation during the operation,which can improve the scar without increasing the recurrence rate.