内镜CO_(2)激光烧灼术与颈部开放性切除术治疗先天性梨状窝瘘患儿的效果比较

Comparison of effects of endoscopic CO_(2)laser cauterization and open neck resection in treatment of children with congenital pyriform sinus fistula

目的:比较内镜CO_(2)激光烧灼术(ECLC)与颈部开放性切除术治疗先天性梨状窝瘘(CPSF)患儿的效果。方法:选取2021年3月至2022年3月该院收治的100例CPSF患儿进行前瞻性研究,按照随机数字表法将其分为对照组和观察组各50例。对照组行颈部开放性切除术治疗,观察组行ECLC治疗。比较两组手术相关指标(手术时间、术中出血量、平均住院时间、胃管留置时间)水平、术后1 d疼痛程度[视觉模拟评分法(VAS)]评分、术后3个月颈部美容评分和术后3、12个月治愈率,以及并发症发生率。结果:观察组手术时间、平均住院时间和胃管留置时间均短于对照组,术中出血量少于对照组,差异有统计学意义(P<0.05);观察组术后1 d VAS评分低于对照组,术后3个月颈部美容评分高于对照组,差异有统计学意义(P<0.05);观察组术后3个月治愈率为82.00%(41/50),低于对照组的100.00%(50/50),差异有统计学意义(P<0.05);两组术后12个月治愈率和并发症发生率比较,差异均无统计学意义(P>0.05)。结论:ECLC治疗CPSF患儿可降低手术相关指标水平和术后疼痛评分,提高颈部美容评分的效果优于颈部开放性切除术治疗,但术后3个月治愈率低于颈部开放性切除术,两种术式术后12个月的治愈率相当。

Objective:To compare effects of endoscopic CO_(2)laser cauterization(ECLC)and open neck resection in treatment of children with congenital pyriform sinus fistula(CPSF).Methods:A prospective study was conducted on 100 children with CPSF admitted to this hospital from March 2021 to March 2022.They were divided into control group and observation group according to the random number table method,50 cases in each group.The control group was treated with open neck resection,while the observation group was treated with ECLC.The operation related index levels(operation time,intraoperative blood loss,average hospitalization time,gastric tube indwelling time),the pain degree[visual analogue scale(VAS)]score 1 day after the surgery,the neck beauty score 3 months after the surgery,the cure rates 3 and 12 months after the surgery,and incidence of complications were compared between the two groups.Results:The operation time,the average hospitalization time and the gastric tube indwelling time of the observation group were shorter than those of the control group,the intraoperative blood loss was less than that of the control group,and the differences were statistically significant(P<0.05).The VAS score of the observation group was lower than that of the control group 1 day after the surgery,the neck beauty score was higher than that of the control group 3 months after the surgery,and the differences were statistically significant(P<0.05).The cure rate of the observation group was 82.00%(41/50)3 months after the surgery,which was lower than 100.00%(50/50)of the control group,and the difference was statistically significant(P<0.05).However,there was no significant difference in the cure rate and complication rate between the two groups at months after the surgery(P>0.05).Conclusions:ECLC in the treatment of the children with CPSF can reduce the levels of surgery-related indexes and the postoperative pain scores,and improve the neck beauty scores.Moreover,it is superior to open neck resection,but the cure rate is lower than that of open neck resection 3 months after the surgery.The cure rates of the two methods are similar 12 months after the surgery.