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目的:总结284例先天性鳃裂囊肿(瘘)病例资料,对其诊断和治疗方法进行探讨。方法:回顾分析1993年6月至2006年12月手术治疗的284例鳃裂囊肿(瘘)的临床资料,包括术前检查、术前诊断和术后病理,随访时间最短6个月,最长120个月,平均37个月。采用SAS6.12软件包对数据进行统计学分析。结果:所有病例均经病理证实为鳃裂囊肿(瘘),其中第一鳃裂囊肿132例,占46.5%;第二鳃裂囊肿145例,占51.1%;第三鳃裂囊肿7例,占2.4%。第一鳃裂囊肿好发于40岁后的中老年,第二、三鳃裂囊肿好发于40岁前的青壮年。术后病理证实原发病变188例,复发病变33例,囊肿伴内瘘44例,囊肿继发感染伴外瘘16例,内、外瘘均有为3例。鳃裂囊肿(瘘)伴结核1例,多囊性囊肿2例,伴静脉畸形1例,恶性变6例(5例来源于第一鳃裂囊肿,1例来源于第二鳃裂囊肿)。术前辅助检查中,B超检查的诊断符合率最高,为66.20%。随访期间,鳃裂囊肿复发率为5.98%。结论:第一、二鳃裂囊肿(瘘)最常见,术前B超检查对鳃裂囊肿(瘘)有较高的确诊率,首次手术完整切除囊肿与瘘管是治疗成功的关键。
Objective: To summarize the data of 284 cases of congenital branchial cleft cyst (fistula) and discuss the diagnosis and treatment methods. Methods: The clinical data of 284 cases of branchial cleft cyst (fistula), including preoperative examination, preoperative diagnosis and postoperative pathology, were retrospectively analyzed from June 1993 to December 2006. The shortest follow-up time was 6 months and the longest 120 months, an average of 37 months. SAS6.12 software package for statistical analysis of the data. Results: All the cases were pathologically confirmed as branchial cleft cysts (fistulas), including 132 cases of the first branchial cleft, accounting for 46.5%, 145 cases of the second branchial cleft, accounting for 51.1%, and 7 cases of the third branchial cleft, accounting for 2.4%. The first branchial cleft cyst occurs in the middle-aged after 40 years of age, the second and three branchial cleft cysts occur in the 40-year-old young adults. Postoperative pathology confirmed 188 cases of primary lesions, 33 cases of recurrent lesions, 44 cases of cyst with fistula, cyst secondary infection with 16 cases of fistula, internal and external fistula were 3 cases. 1 case of branchial cleft cyst (fistula) with tuberculosis, 2 cases of polycystic cyst, 1 case of venous malformation, 6 cases of malignant transformation (5 cases originated from the first branchial cleft cyst and 1 case from the second branchial cleft). Preoperative examination, B-ultrasound diagnosis of the highest coincidence, was 66.20%. During follow-up, the recurrence rate of the branchial cleft cyst was 5.98%. Conclusions: First, the most common branchial fissure (fistula) and preoperative ultrasound B have a higher diagnosis rate of branchial cleft cyst (fistula). The first complete surgical resection of the cyst and fistula is the key to successful treatment.