摘要
目的总结29例先天性鳃裂囊肿(瘘)病例资料,对其诊疗方法进行探讨。方法回顾性分析1999年9月～2009年12月手术治疗的29例鳃裂囊肿及瘘管的临床资料,包括术前检查、诊疗、术后病理诊断。结果术后病理均确诊为鳃裂囊肿或瘘管,B超诊断囊肿符合率最高为72.2%(13/18),40%碘油X线造影诊断瘘管符合率最高为63.6%(7/11),第一鳃裂囊肿(瘘)误诊率为54.5%(6/11),手术治疗29例,随访6个月～12年,2例复发,经扩大切除,随访至今未再复发。结论 B超对鳃裂囊肿诊断有较高的确诊率,而碘油X线造影对瘘管有较高的确诊率,第一鳃裂囊肿(瘘)易误诊。
OBJECTIVE To investigate the clinical manifestation of branchial cleft cyst （fistula） and provide some clinical experience on its diagnosis and treatment.METHODS The clinical data of 29 patients with branchial cleft cyst or fistula underwent surgical treatment from Sep.1999 to Dec. 2009 were retrospectively reviewed. The preoperative examinations, preoperative diagnosis and postoperative pathological diagnosis were recorded. RESULTS Among the 29 patients with branchial cleft cyst or fistula confirmed by postoperative pathology, ultrasonography had the highest accuracy for preoperative diagnosis of branchial cleft cyst （72.2 %, 13/18） , and the 40% lipiodol X radiography had the highest accuracy for preoperative diagnosis of branchial cleft fistula （63.6%, 7/11） . The first branchial cleft cyst （fistula） misdiagnosis rate was 54.5% （6/11） . All the 29 cases underwent surgical resection. Two patients recurred after follow up for 0.5 to 12 years. The expanded resection were performed for the 2 patients and no recurrence occurred until now. CONCLUSION Preoperative ultrasonography is the first choice for diagnosis of branchial cleft cyst, preoperative 40% lipiodol X radiography is the first choice for diagnosis of branchial cleft fistula. The first branchial cleft cyst （fistula） is easy to be misdiagnosed. Complete resection including the cyst and fistula is the only treatment method.
出处
《中国耳鼻咽喉头颈外科》
CSCD
2013年第8期435-438,共4页
Chinese Archives of Otolaryngology-Head and Neck Surgery
关键词
鳃区
囊肿
瘘
外科手术
误诊
Branchial Region
Cysts
Fistula
SurgicalProcedures, Operative
Diagnostic Errors
作者简介
邹上初，男，湖南人，医学硕士，主治医师，主要从事耳鼻咽喉头颈外科临床工作。Email：zoushangchu@163．com
通讯作者：罗志强（Email：zhiqjanglu09656@126．com）
