耳前瘘管合并感染脓肿期手术切除的疗效观察

Curative effect of surgical resection of preauricular fistula complicated with infection and abscess

摘要:

目的探讨耳前瘘管合并感染期瘘管切除的可行性和临床疗效。方法收集2013年1月～2016年12月诊治的耳前瘘管合并感染脓肿期患者76例，其中男39例，女37例，年龄2～43岁；均单耳发病，左29耳，右47耳。全身积极给予抗感染治疗24 h内，对所有患者同时行脓肿、瘘管及炎性组织切除术，按常规方法切开、剥离、切除瘘管至感染后肿胀脓肿形成或肉芽形成或自行破溃的病变组织，切除或刮除病变组织至正常组织明显处,减张间断缝合，消除死腔，通过随访进行疗效观察。结果76例患者中，73例患者均Ⅰ期愈合，3例患者局部皮肤轻度红肿，延迟2 d拆线。无局部感染、裂开及瘢痕等并发症，术后随访1~3年未见复发。结论耳前瘘管感染脓肿期将瘘管、脓肿及炎性组织一并切除能够达到一期愈合的目的，减少了患者二次手术、换药的痛苦，缩短了住院时间，与常规手术比较具有同样的手术疗效，值得临床推广应用。

Abstract:

ObjectiveTo investigate the feasibility and clinical efficacy of surgical resection of preauricular fistula complicated with infection and abscess.MethodsFrom Jan 2013 to Dec 2016, 76 patients suffering from preauricular fistula combined with infection and abscess underwent surgical resection in our department. Of them, 39 were male and 37 were female, aged from 2 to 43 years old. Single ear was affected in all cases, including left ear in 29 and right in 47. After systemic antiinfective therapy for 24 hours, surgical resection of foci including fistula, abscess and inflammatory tissue was performed in all patients. During the surgical procedure, the fistula combined with abscess and granulation tissue was excised, stripped and removed to expose the normal tissue. The incision was sewn up by intermittent tensionreduced suture to eliminate the dead cavity. All patients were followed up to observe the therapeutic effect.ResultsOf all the 76 patients, 73 were healed in the first stage, and removal of the stitches was belayed by 2 days in 3 cases due to mild redness and distension in local skin. There were no complications such as local infection, fracture and scar. No recurrence was observed 1 to 3 years after operation.ConclusionWith advantages of achieving firststage healing, reducing additional suffering due to reoperation and dressing change, and shortening hospital stays, the surgical resection of fistula, abscess and inflammatory tissue for preauricular fistula compliatced with infection and abscess may have the same therapeutic effect as routine surgery, and is therefore worthy of clinical promotion and application.