双梭形切口术和单切口术治疗先天性耳前瘘管的效果比较

Comparison of effects of double shuttle incision and single incision in the treatment of congenital preauricular fistula

目的比较双梭形切口术和单切口术治疗先天性耳前瘘管的效果,并对手术经验进行总结。方法选择2016年1月至2021年1月收治的62例先天性耳前瘘管患者作为研究对象,根据入院顺序编号后将患者随机分为参照组和观察组,每组31例。参照组采取单切口术治疗,观察组采取双梭形切口术治疗。比较两组的临床疗效、满意度、炎症因子水平及不良事件发生情况。结果观察组的治疗总有效率为100.00%,高于参照组的87.10%,差异具有统计学意义(P<0.05)。观察组的满意度为96.77%,高于参照组的80.65%,差异具有统计学意义(P<0.05)。治疗前1 d,两组的TNF-α、IL-8、PAF、IL-6水平比较,差异无统计学意义(P>0.05);治疗后1周,两组的TNF-α、IL-8、PAF、IL-6水平均较治疗前1 d显著降低,且观察组低于参照组,差异具有统计学意义(P<0.05)。两组的伤口感染、腮腺损伤发生率比较,差异无统计学意义(P>0.05);观察组的皮瓣部分愈合不良发生率显著低于参照组,差异具有统计学意义(P<0.05)。结论相较于单切口术,双梭形切口术治疗先天性耳前瘘管的临床效果更为显著,可明显减轻机体炎症反应,降低皮瓣部分愈合不良发生率,且患者的满意度更高,值得临床推广和应用。

Objective To compare the effects of double shuttle incision and single incision in the treatment of congenital preauricular fistula,and summarize the experience of operation.Methods Sixty-two patients with congenital preauricular fistula treated from January 2016 to January 2021 were selected as the study objects.The patients were randomly divided into reference group and observation group after numbering according to the admission order,with 31 cases in each group.The reference group was treated with single incision,and the observation group was treated with double shuttle incision.The clinical efficacy,satisfaction,inflammatory factors levels and occurrence of adverse events were compared between the two groups.Results The total effective rate of treatment in the observation group was 100.00%,which was higher than 87.10%in the reference group,and the difference was statistically significant(P<0.05).The satisfaction in the observation group was 96.77%,which was higher than 80.65%in the reference group,and the difference was statistically significant(P<0.05).At 1 d before treatment,there were no significant differences in the levels of TNF-α,IL-8,PAF and IL-6 between the two groups(P>0.05);at one week after treatment,the levels of TNF-α,IL-8,PAF and IL-6 in the two groups were significantly lower than those at 1 d before treatment,those in the observation group were lower than the reference group,and the differences were statistically significant(P<0.05).There were no significant differences in the incidences of wound infection and parotid gland injury between the two groups(P>0.05);the incidence of partial poor flap healing in the observation group was significantly lower than that in the reference group,and the difference was statistically significant(P<0.05).Conclusion Compared with single incision,double shuttle incision in the treatment of congenital preauricular fistula has more significant clinical effect,which can significantly reduce the inflammatory reaction of the body,decrease the incidence of partial poor flap healing,with higher satisfaction of patients,which is worthy of clinical promotion and application.