感染期和非感染期先天性耳前瘘管患者行手术治疗的临床效果比较

王晓锋 李嘉 张志雄 黎雄文 叶远航

[摘要]目的 比較感染期和非感染期先天性耳前瘘管患者行手术治疗的临床效果。方法 选取2016年1月～2018年12月我院收治的35例先天性耳前瘘管感染患者作为观察组，另外选取同期我院收治的35例先天性耳前瘘管非感染患者作为参照组。两组患者均根据其病灶情况采用适宜的手术方式治疗。比较两组患者的术后愈合情况，调查患者对术后美观的满意情况，并随访统计两组患者的术后感染及复发情况。结果 两组手术治疗的Ⅰ期愈合率、Ⅱ期愈合率比较，差异无统计学意义（P>0.05）。两组治疗的美观总满意度比较，差异无统计学意义（P>0.05）。术后随访6个月，两组患者的术后感染发生率及复发率比较，差异无统计学意义（P>0.05）。结论 先天性耳前瘘管患者在感染期施以手术方式治疗，与在非感染期手术治疗的效果及美观满意度相似，因此患者无需等到感染消退后再手术，还能缩短患者的病程和减轻痛苦，值得进一步研究。

[关键词]手术治疗;先天性;耳前瘘管;感染期;非感染期;临床效果;复发率

[中图分类号] R764.1          [文献标识码] A          [文章编号] 1674-4721（2020）3（c）-0098-03

Clinical effect comparison of surgical treatment for patients with congenital preauricular fistula in infected and non-infected period

WANG Xiao-feng   LI Jia   ZHANG Zhi-xiong   LI Xiong-wen   YE Yuan-hang

The Second Department of Otolaryngology， Meizhou People′s Hospital， Guangdong Province， Meizhou   514031， China

[Abstract] Objective To compare the clinical effect of surgical treatment for patients with congenital preauricular fistula during infected and non-infected period. Methods Patients with congenital anterior fistula in infected period admitted to our hospital from January 2016 to December 2018 were enrolled as the observation group （n=35）， and patients in non-infected period admitted at the corresponding time were selected as the reference group （n=35）. Both groups of patients were treated with appropriate surgical methods according to their lesion situation. The postoperative healing of the surgical treatment between the two groups was compared. The patients′ satisfaction with the postoperative appearance was investigated. The postoperative infection and recurrence of the two groups were followed up. Results There were no significant differences between the two groups in the first-stage healing rate， the second-stage healing rate （P>0.05）. There was no significant difference between the two groups in satisfaction in appearance （P>0.05）. There were no significant differences between the two groups in postoperative infection rate and recurrence rate during 6-month follow up visits （P>0.05）. Conclusion Surgical treatment of congenital preauricular fistula patients during infection period is similar to surgical treatment during non-infeced period in therapeutic effect and satisfaction in appearance. Therefore， patients can undergo surgical treatment before the resolution of infection， which can shorten the course and alleviate pain， and is worthy of further study.

[Key words] Surgical treatment; Congenital; Preauricular fistula; Infected period; Non-infected period; Clinical effect; Recurrence rate

先天性耳前瘘管是临床常见的耳鼻喉科疾病。它属于先天性的外耳疾病，可呈常染色体显性遗传[1-2]。患者没有明显的临床症状，而瘘管多表现为长短不一的狭窄窦道或盲管，瘘管可呈分支样，按压管腔内可见有少许乳白色豆渣样物或黏液溢出[3]。先天性耳前瘘管容易出现感染，且往往反复发作[4]。数据统计显示[5]，感染型的先天性耳前瘘管在其中占比80%以上，而先天性耳前瘘管发生感染的患者在瘘管附近会出现化脓及肿痛。先天性耳前瘘……