本文選題：鰓裂囊腫　切入點(diǎn)：微創(chuàng)手術(shù)　出處：《吉林大學(xué)》2014年碩士論文　論文類型：學(xué)位論文

【摘要】：目的：評(píng)估微創(chuàng)手術(shù)作為一種新的治療鰓裂囊腫的方法的可行性。 背景：鰓裂囊腫是頭頸部腫瘤中的一種常見疾病，屬于先天性疾病，病因機(jī)制不甚明確，根據(jù)發(fā)病來源將其分為四類，其中第二鰓裂囊腫在臨床上最為常見，位置多在單側(cè)頸部。其手術(shù)治療方法可作為頸部腫瘤手術(shù)切除的代表。傳統(tǒng)的第二鰓裂囊腫切除術(shù)即在頸部做一全層橫斷切口，這樣不僅影響美觀，手術(shù)創(chuàng)傷也大，手術(shù)及術(shù)后恢復(fù)時(shí)間較長(zhǎng)，術(shù)后疼痛反應(yīng)重，瘢痕較為明顯。頸部是需要暴露在外的區(qū)域，并且考慮到鰓裂囊腫的好發(fā)年齡多為年輕人，美觀是個(gè)需要重視的問題。微創(chuàng)手術(shù)在創(chuàng)口小，美觀，損傷小等方面有巨大優(yōu)勢(shì)，早期專指腹腔鏡手術(shù)，近年來已經(jīng)被學(xué)者們嘗試應(yīng)用于各個(gè)領(lǐng)域和部位。 材料與方法：選取2007年至2009年間就診于我院的26名患有第二鰓裂囊腫的患者進(jìn)行臨床研究。在經(jīng)過患者及家屬同意下，將其分為兩組，實(shí)驗(yàn)組中有15名患者采用微創(chuàng)手術(shù)來治療，對(duì)照組中11名患者采用傳統(tǒng)方法進(jìn)行治療。所有入組患者均有詳細(xì)記錄的病史，病程記錄以及手術(shù)記錄等資料，實(shí)驗(yàn)室輔助檢查結(jié)果以及病理結(jié)果均有記錄。通過對(duì)兩組患者的手術(shù)麻醉方式，手術(shù)時(shí)間，術(shù)后疼痛程度，切口大小以及兩年隨訪的結(jié)果來評(píng)估新方法的可行性。 結(jié)果：通過實(shí)驗(yàn)研究對(duì)比，實(shí)驗(yàn)組的手術(shù)方法，即采用微創(chuàng)的手術(shù)，主要采用局部麻醉來進(jìn)行，整個(gè)手術(shù)過程平均時(shí)長(zhǎng)為52.0分鐘，較傳統(tǒng)手術(shù)方法平均時(shí)長(zhǎng)的70.45分鐘明顯縮短。另外，實(shí)驗(yàn)組中，微創(chuàng)手術(shù)所形成的切口平均長(zhǎng)度為2.17厘米，對(duì)照組為5.59厘米。實(shí)驗(yàn)組患者術(shù)后不良反應(yīng)及疼痛明顯較對(duì)照組減少。兩年隨訪兩組病例中，未見有復(fù)發(fā)病例；實(shí)驗(yàn)組患者平均瘢痕長(zhǎng)度較對(duì)照組的明顯較短，，且對(duì)照組病例均有較明顯的瘢痕。 結(jié)論：微創(chuàng)手術(shù)可以作為治療鰓裂囊腫的一種，并在一定程度上能更好的被患者接受。
[Abstract]:Objective: to evaluate the feasibility of minimally invasive surgery as a new method for the treatment of branchial cleft cysts. Background: branchial cleft cyst is a common disease in head and neck tumors. It is a congenital disease, and its etiology is not clear. According to its origin, branchial cleft cyst is classified into four categories, among which the second branchial cleft cyst is the most common in clinic. The traditional resection of the second branchial cleft cyst is to make a full-layer incision in the neck, which not only affects the beauty, but also has a great trauma. The neck is the area that needs to be exposed, and considering that the most common age of branchial cleft cysts is young people. Minimally invasive surgery has great advantages in the aspects of small wound, beautiful appearance, little injury, etc. In recent years, it has been applied to various fields and parts by scholars. Materials and methods: 26 patients with second branchial cleft cyst from 2007 to 2009 were selected and divided into two groups with the consent of the patients and their families. Fifteen patients in the experimental group were treated with minimally invasive surgery, 11 patients in the control group were treated with traditional methods. The feasibility of the new method was evaluated by anaesthesia, operation time, postoperative pain, incision size and two-year follow-up results. Results: compared with the experimental study, the operation methods of the experimental group, I. e., the minimally invasive operation, were mainly performed by local anesthesia. The average duration of the whole operation process was 52.0 minutes. In addition, in the experimental group, the average length of incision formed by minimally invasive surgery was 2.17 cm. The adverse reactions and pain in the experimental group were significantly lower than those in the control group. There were no recurrence cases in the two groups, and the average scar length in the experimental group was significantly shorter than that in the control group, and the mean scar length in the experimental group was significantly shorter than that in the control group. All the cases in the control group had obvious scar. Conclusion: minimally invasive surgery can be used to treat branchial cleft cysts and to some extent be better accepted by patients.
【學(xué)位授予單位】：吉林大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R782.7

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