Zhao Dongjihui,Li Yun,Huang Min,et al.Clinical analysis of incision-and-drainage of cervical abscess plus suspension laryngoscopic low-temperature plasma radiofrequency ablation for neonatal congenital pyriform sinus fistula in abscess stage[J].Journal of Clinical Pediatric Surgery,2025,(06):587-591.[doi:10.3760/cma.j.cn101785-202412053-015]
颈部脓肿切开引流术联合支撑喉镜下低温等离子射频消融术治疗新生儿脓肿期先天性梨状窝瘘
- Title:
- Clinical analysis of incision-and-drainage of cervical abscess plus suspension laryngoscopic low-temperature plasma radiofrequency ablation for neonatal congenital pyriform sinus fistula in abscess stage
- Keywords:
- Congenital Pyriform Sinus Fistula; Abscess; Neck; Surgical Procedures; Operative; Drainage; Radiofrequency Ablation; Treatment Outcome; Infant; Newborn
- 摘要:
- 目的 探讨颈部脓肿切开引流术联合支撑喉镜下低温等离子射频消融术治疗新生儿脓肿期先天性梨状窝瘘(congenital pyriform sinus fistula,CPSF)的可行性。方法 回顾性分析2020年1月至2024年1月湖南省儿童医院新生儿科收治的17例脓肿期CPSF患儿临床资料,基于家属选择分为联合消融引流组及单纯引流组。其中联合消融引流组11例,采用颈部脓肿切开引流术联合支撑喉镜下低温等离子射频消融术治疗;单纯引流组6例,仅采用颈部脓肿切开引流术治疗。主要观察指标为术中出血量、住院时间、手术时间及复发率。结果 两组性别、出生时孕周、出生体重、手术时年龄、Apgar评分、瘘管侧别、发热人数占比、存在呼吸困难需干预人数占比、脓肿大小等差异均无统计学意义(P＞0.05)。联合消融引流组及单纯引流组患儿术中出血量[(5.21±2.44)mL比(4.76±3.14)mL]、住院时间[(20.45±3.99)d 比(21.01±4.26)d]差异无统计学意义(P＞0.05);手术时间[(62.51±14.16)min比(34.72±9.136)min]及复发率(1/11比6/6)差异均有统计学意义(P<0.001)。结论 颈部脓肿切开引流术联合支撑喉镜下低温等离子射频消融术治疗新生儿脓肿期CPSF具有微创、高成功率、低复发率的优势,是一种安全、有效的治疗方式,临床可选择应用。
- Abstract:
- Objective To assess the feasibility of combining cervical abscess incision-and-drainage with suspension laryngoscopic low-temperature plasma radiofrequency ablation in treating neonatal congenital pyriform sinus fistula (CPSF) during abscess stage. Methods Clinical data of 17 neonates with abscess-stage CPSF treated in Hunan Children’s Hospital from January 2020 to January 2024 were reviewed.According to parental choice,patients were divided into a combined ablation-and-drainage group (n=11) and a simple drainage group (n=6).The combined group underwent cervical abscess incision-and-drainage plus low-temperature plasma radiofrequency ablation of the fistula via suspension laryngoscope;the simple group received drainage alone.Intra-operative blood loss,length of hospital stay,operation time,and recurrence rate were compared. Results No significant differences between found between groups in sex,gestational age,birthweight,age at surgery,Apgar score,side of the fistula,proportion with fever,proportion requiring respiratory intervention,or abscess size (P>0.05).Intra-operative blood loss[(5.21±2.44) mL vs.(4.76±3.14) mL] and hospital stay [(20.45±3.99) d vs.(21.01±4.26) d] were similar (P>0.05).Operation time and recurrence rate (1/11 vs. 6/6) differed significantly (P<0.001). Conclusions For neonatal CPSF in the abscess stage,cervical abscess incision-and-drainage combined with suspension laryngoscopic low-temperature plasma radiofrequency ablation is a safe,minimally invasive approach with a high success rate and low recurrence,and can be considered for clinical use.
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备注/Memo
收稿日期:2024-12-19。
基金项目:湖南省级科技重大专项(2019SK1015)
通讯作者:黄敏,Email:3150612129@qq.com