人工耳蜗植入术远期植入体周围血肿及血清肿的干预及预后

Intervention and prognosis of hematoma and seroma around implants long-term after cochlear implantation

目的分析和总结人工耳蜗植入患者远期出现的植入体周围血肿及血清肿,探讨其出现的可能原因、临床处理方法和预后。方法对2009~2016年在我院由同一名手术医师完成的人工耳蜗植入手术且随访资料较为完整的1 244例患者进行回顾性研究。结果在1 244例患者中,出现远期植入体周围血肿8例,均为儿童,发生率为0.6%,均由头部碰撞引起,经单次或多次穿刺抽液及加压包扎后全部痊愈;出现不明原因远期植入体周围血清肿3例,亦均为儿童,发生率为0.2%,且2例有反复发作史,经单次或多次穿刺抽液及加压包扎后全部痊愈。结论人工耳蜗植入术远期植入体周围血肿及血清肿发生率较低,血肿主要由头部撞伤引起,而血清肿目前原因不明。无论是血肿还是血清肿,采用单次或多次穿刺抽液及加压包扎进行处理预后良好。

Objective To analyze and summarize the long-term peri-implant hematoma and seroma in patients with cochlear implantation, and to discuss the possible causes, clinical treatment and prognosis. Methods A retrospective study was conducted on 1 244 patients who had undergone cochlear implantation by the same surgeon in our hospital from 2009 to 2016 and had relatively complete follow-up data. Results Among the 1 244 patients, a total of 8 patients with long-term periimplant hematoma were observed, with an incidence of 0.6%. The 8 patients were all children and were caused by head collision. They all recovered after single or multiple puncture drainage and pressure dressing. A total of 3 patients with longterm peri-implant seroma had unknown cause, with an incidence of 0.2%. The 3 patients were children and had a history of recurrent attacks. They recovered completely after single or multiple puncture drainage and pressure dressing. Conclusions The incidence of hematoma and seroma around implants long after cochlear implantation were low. the hematoma was usually caused by head impact,while the reason of seroma was unknown at present. Treatment with single or multiple puncture drainage and compression dressing has a good prognosis for both situations.