本文選題：鰓裂畸形 + 先天性疾病　； 參考：《吉林大學(xué)》2012年碩士論文

【摘要】：目的：通過總結(jié)分析63例鰓裂畸形病例臨床資料，進一步探討鰓裂畸形發(fā)病特點，探究更為優(yōu)化的治療方案。 方法：收集吉大一院2005年至2012年鰓裂畸形病例。根據(jù)鰓裂畸形的位置，分為第一鰓裂畸形，第二鰓裂畸形，第三、四鰓裂畸形。統(tǒng)計患者性別、發(fā)病年齡、病程時間、主訴及伴隨癥狀、是否有頸部感染史、是否有手術(shù)史、輔助檢查結(jié)果、手術(shù)方式的選擇、術(shù)后病理情況、術(shù)后并發(fā)癥的發(fā)生及術(shù)后隨訪是否有復(fù)發(fā)。進而分析鰓裂畸形發(fā)病臨床特點、輔助檢查的選擇及優(yōu)勢、鑒別診斷、手術(shù)方式的選擇、術(shù)后復(fù)發(fā)的原因、鰓裂癌臨床特點。 結(jié)果：63例病例中，第一鰓裂畸形15例，第二鰓裂畸形36例，第三、四鰓裂畸形12例，鰓裂畸形中男性病例為32例，女性病例31例。鰓裂畸形平均發(fā)病年齡約為22歲。鰓裂畸形平均病程為33個月。鰓裂畸形中左側(cè)有44例，右側(cè)有15例，雙側(cè)2例，正中2例。術(shù)后病理鰓裂囊腫49例，鰓裂瘺管14例。鰓裂畸形有43例術(shù)前行超聲檢查，9例術(shù)前行CT檢查。第一鰓裂畸形13例手術(shù)切除腫物，1例行膿腫切開引流術(shù)，1例行保守治療；第二鰓裂囊腫中有25例腫物切除術(shù)，9例行膿腫切開引流術(shù)，1例行扁桃體切除加囊腫切除術(shù)，1例行保守治療；第三、四鰓裂囊腫8例行腫物切除術(shù)，3例行膿腫切開引流，1例行鰓裂囊腫切除加甲狀腺左葉部分切除術(shù)。術(shù)后并發(fā)癥2例，頸部切口感染1例，暫時性喉返神經(jīng)麻痹1例。有8例鰓裂畸形術(shù)前有膿腫切開引流術(shù)。術(shù)后隨訪有3例術(shù)后復(fù)發(fā)，再次手術(shù)。鰓裂癌1例，腫物位于右側(cè)伴頸部淋巴結(jié)轉(zhuǎn)移，行右側(cè)選擇性頸淋巴結(jié)清掃術(shù)。 結(jié)論：鰓裂畸形以兒童期發(fā)生率最高，隨年齡增長發(fā)生率遞減�；颊咂骄〕梯^長，不同鰓裂畸形發(fā)病特點不同導(dǎo)致平均病程不同。鰓裂畸形發(fā)病以第二鰓裂畸形為主，但第一鰓裂畸形及第三、四鰓裂畸形，發(fā)病率實際上并不低。鰓裂畸形以左側(cè)較右側(cè)多見。鰓裂畸形手術(shù)復(fù)發(fā)原因主要包括術(shù)前感染史，鰓裂畸形分支的處理，與周圍結(jié)構(gòu)的解剖關(guān)系，內(nèi)瘺口的處理，診治經(jīng)過及患者自身原因等。
[Abstract]:Objective: to summarize and analyze the clinical data of 63 patients with branchial cleft deformity, to explore the characteristics of Gill cleft malformation and to explore a better treatment scheme. Methods: the patients with branchial cleft deformity from 2005 to 2012 were collected. According to the location of the branchial cleft malformation, it can be divided into the first branchial cleft malformation, the second branchial cleft malformation and the third and fourth branchial cleft malformation. Gender, age of onset, duration of disease, main complaint and associated symptoms, history of neck infection, history of operation, results of auxiliary examination, choice of operation mode, postoperative pathological situation, The occurrence of postoperative complications and postoperative follow-up whether there is recurrence. Then the clinical characteristics of Gill cleft deformity, the choice and advantage of auxiliary examination, the differential diagnosis, the choice of operation mode, the cause of postoperative recurrence and the clinical characteristics of Gill cleft carcinoma were analyzed. Results among 63 cases, 15 cases were first branchial cleft malformation, 36 cases were second branchial cleft malformation, 12 cases were third and fourth branchial cleft malformation, 32 cases were male and 31 cases were female. The average onset age of branchial cleft deformity was about 22 years old. The mean duration of branchial cleft deformity was 33 months. 44 cases were left side, 15 cases were right side, 2 cases were bilateral and 2 cases were median. Postoperative pathological branchial cleft cysts in 49 cases, branchial fistula in 14 cases. 43 cases of branchial cleft deformity were examined by ultrasound before operation and 9 cases by CT before operation. 13 cases of the first branchial cleft deformity were surgically removed and 1 case underwent abscess incision and drainage and 1 case was treated conservatively. Of the second branchial cleft cysts, 25 cases were treated with tumor excision 9 cases with abscess incision and drainage and 1 case with tonsillectomy plus cystectomy and 1 case with conservative treatment. Four branchial cleft cysts were resected in 8 cases and abscess incision and drainage were performed in 3 cases. Branchial cleft cyst resection and partial thyroidectomy were performed in 1 case. Postoperative complications in 2 cases, cervical incision infection in 1 case, temporary recurrent laryngeal nerve paralysis in 1 case. Abscess incision and drainage were performed in 8 patients with branchial cleft malformation before operation. There were 3 cases of postoperative recurrence and reoperation. One case of branchial cleft carcinoma, the tumor located in the right with cervical lymph node metastasis, right selective neck lymph node dissection. Conclusion: the incidence of branchial cleft deformity is the highest in childhood and decreases with age. The mean course of disease was longer, and the characteristics of different branchial deformities resulted in different mean course of disease. The main malformation of branchial cleft was the second branchial cleft, but the first branchial deformity and the third and fourth branchial deformity had not low incidence. Branchial cleft deformity was more common in left side than in right side. The causes of surgical recurrence of Gill cleft deformity include the history of infection before operation, the treatment of branchial branches of Gill cleft deformity, the anatomical relationship with the surrounding structure, the treatment of internal fistula, the diagnosis and treatment, and the causes of the patients themselves.
【學(xué)位授予單位】：吉林大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2012
【分類號】：R762

【參考文獻】

相關(guān)期刊論文 前1條

1 邱宇;林李嵩;施斌;朱小峰;林耿冰;黃立;黃躍;;原發(fā)性鰓裂癌4例臨床分析[J];中國口腔頜面外科雜志;2010年05期

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本文編號：2078419